Figure 1.
OM and dysbiosis correlated with cGVHD in allo-HCT recipients. (A) The study flow chart for the retrospective cohort of allo-HCT recipients excluding those that received a haploidentical HCT with antithymocyte globulin due to persistent disease and a high-risk comorbidity index is shown. Outcomes for patients with (grades 2-3) or without moderate-to-severe OM are shown (B-D). The statistical significance between the 2 groups in panels B and C was assessed using the Gray test to account for competing risks. (B) The cumulative incidence of aGVHD (grades 3-4) 180 days after allo-HCT between the 2 groups described in panel A is shown. (C) The cumulative incidence of cGVHD (limited and extensive) 60 months after allo-HCT is shown for patients with (grades 2-3) or without moderate-to-severe OM. (D) The cumulative proportion of GRFS 60 months after allo-HCT is shown for the patient groups described in panel A. Statistical significance between the 2 groups was determined using the log-rank test with aGVHD (grades 3-4), cGVHD (extensive), relapse, and death as events. (E) The study flow chart for the retrospective cohort of patients receiving a haplo-PTCy is shown. Outcomes for patients with (grades 2-3) or without moderate-to-severe OM are shown (F-H). The statistical significance between the 2 groups in panels F and G was assessed using the Gray test to account for competing risks. (F) The cumulative incidence of aGVHD (grades 3-4) 180 days after haplo-PTCy is shown for the patient groups described in panel E. (G) The cumulative incidence of cGVHD (limited and extensive) at 36 months after haplo-PTCy is shown for the patient groups described in panel E. (H) Cumulative proportion of GRFS at 36 months after haplo-PTCy is shown for the patient groups described in panel E. Statistical significance between the 2 groups was determined using the log-rank test with aGVHD (grades 3-4), cGVHD (extensive), relapse, and death as events. (I) The relative abundance of buccal mucosa microbiota (family level) preconditioning and at engraftment for patients who did or did not go on to develop cGVHD (n = 15 without cGVHD, n = 16 with cGVHD) is shown. (J) Principal coordinate analysis (PCoA) by analysis of molecular variance (AMOVA) of buccal mucosa microbiota family composition from each patient before conditioning and at engraftment for patients who did or did not go on to develop cGVHD (n = 15 without cGVHD, n = 16 with cGVHD) is shown. (K) α-Diversity (Shannon index) of buccal mucosa microbiota before and after HCT for each group are shown. Statistical significance between those with (n = 16) and without (n = 15) cGVHD was determined using the Mann-Whitney U test (∗∗P < .01; ∗∗∗P < .001). Error bars represent the mean ± the standard deviation (SD). (L) Changes in α-diversity (Shannon index) of buccal mucosa microbiota before conditioning and at engraftment for each group are shown. Shannon index ratio = Shannon index at engraftment/Shannon index before conditioning. Statistical significance between those with (n = 16) and without (n = 15) cGVHD was determined using the Mann-Whitney U test (∗∗P < .01). Error bars represent the mean ± the SD. PC, principal coordinate.

OM and dysbiosis correlated with cGVHD in allo-HCT recipients. (A) The study flow chart for the retrospective cohort of allo-HCT recipients excluding those that received a haploidentical HCT with antithymocyte globulin due to persistent disease and a high-risk comorbidity index is shown. Outcomes for patients with (grades 2-3) or without moderate-to-severe OM are shown (B-D). The statistical significance between the 2 groups in panels B and C was assessed using the Gray test to account for competing risks. (B) The cumulative incidence of aGVHD (grades 3-4) 180 days after allo-HCT between the 2 groups described in panel A is shown. (C) The cumulative incidence of cGVHD (limited and extensive) 60 months after allo-HCT is shown for patients with (grades 2-3) or without moderate-to-severe OM. (D) The cumulative proportion of GRFS 60 months after allo-HCT is shown for the patient groups described in panel A. Statistical significance between the 2 groups was determined using the log-rank test with aGVHD (grades 3-4), cGVHD (extensive), relapse, and death as events. (E) The study flow chart for the retrospective cohort of patients receiving a haplo-PTCy is shown. Outcomes for patients with (grades 2-3) or without moderate-to-severe OM are shown (F-H). The statistical significance between the 2 groups in panels F and G was assessed using the Gray test to account for competing risks. (F) The cumulative incidence of aGVHD (grades 3-4) 180 days after haplo-PTCy is shown for the patient groups described in panel E. (G) The cumulative incidence of cGVHD (limited and extensive) at 36 months after haplo-PTCy is shown for the patient groups described in panel E. (H) Cumulative proportion of GRFS at 36 months after haplo-PTCy is shown for the patient groups described in panel E. Statistical significance between the 2 groups was determined using the log-rank test with aGVHD (grades 3-4), cGVHD (extensive), relapse, and death as events. (I) The relative abundance of buccal mucosa microbiota (family level) preconditioning and at engraftment for patients who did or did not go on to develop cGVHD (n = 15 without cGVHD, n = 16 with cGVHD) is shown. (J) Principal coordinate analysis (PCoA) by analysis of molecular variance (AMOVA) of buccal mucosa microbiota family composition from each patient before conditioning and at engraftment for patients who did or did not go on to develop cGVHD (n = 15 without cGVHD, n = 16 with cGVHD) is shown. (K) α-Diversity (Shannon index) of buccal mucosa microbiota before and after HCT for each group are shown. Statistical significance between those with (n = 16) and without (n = 15) cGVHD was determined using the Mann-Whitney U test (∗∗P < .01; ∗∗∗P < .001). Error bars represent the mean ± the standard deviation (SD). (L) Changes in α-diversity (Shannon index) of buccal mucosa microbiota before conditioning and at engraftment for each group are shown. Shannon index ratio = Shannon index at engraftment/Shannon index before conditioning. Statistical significance between those with (n = 16) and without (n = 15) cGVHD was determined using the Mann-Whitney U test (∗∗P < .01). Error bars represent the mean ± the SD. PC, principal coordinate.

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