Faecal microbiota transfer for treating refractory acute graft-versus-host disease with gastrointestinal involvement after 2 systemic therapies

Faecal microbiota transfer (FMT) is intended for the treatment of adults with acute graft-versus-host disease (aGvHD) which affects the gut (gastrointestinal involvement). FMT is used when the disease does not get better after steroid treatment (steroid refractory) nor with a second-line treatment. GvHD means the graft (the donated bone marrow or stem cells) has attacked the host (the recipient of the donated graft). This can happen after a transplant from another person, which is also called an allogeneic transplant. In GvHD, donor white blood cell (T cells) in the donated bone marrow or stem cells attack the host’s body cells. This is because the graft sees the host body cells as foreign. aGvHD usually develops within the first 100 days following a transplant. Symptoms can include stomach ache, nausea, and loss of appetite. A sore mouth and unintentional weight loss may also develop. Patients with steroid refractory/ruxolitinib resistance GI aGvHD have very few treatment options left and often do not survive long.