Allogeneic hematopoietic cell transplantation (allo-HCT) is the only curative procedure to date for many hematological malignancies. This is a life-saving but dangerous procedure, with high rates of treatment-related complications, including graft-versus-host disease (GVHD) where transplanted immune cells identify the host as foreign and attack the recipient’s cells.

GVHD commonly emerges at primary host-microbial interfaces including skin, gut, and lung, which implies a potential involvement of microbiome disruption. We hypothesize that host, donor, and microbial factors cumulatively influence a patient’s risk of adverse events following allo-HCT.

In this study, we investigate the impact of the gut microbiome on clinical outcomes (GVHD, infection, relapse) and its relationship with acute and chronic GVHD development by characterizing and combining clinical, microbiome, metabolome data from a cohort of 100 allo-HCT patients over time. Additionally, we aim to form a robust hybrid biomarker for predicting GVHD risk and customizing treatment, focusing on microbial genetic and metabolic mechanisms.

Our study uniquely combines microbiome, metabolome, and immune reconstitution data with clinical outcomes for predictive modeling in allo-HCT, providing unprecedented insights into host-microbiome interactions influencing GVHD, infection, and relapse. Understanding these connections is crucial for personalized patient care in lymphoma and other blood cancers. Ultimately, this will lead to enhanced quality of care, reducing the risk of complications, and improving patient survival following allo-HCT.

This project brings together the diverse clinical expertise in hematology, dermatology and infectiology from the University Hospital Basel with the ETH Zurich’s state-of-the-art bioanalytics, diagnostics, and data science, as well as extensive combined experience in microbiome research.