Third-party fecal microbiota transplantation following allo-HCT reconstitutes microbiome diversity by Zachariah DeFilipp, Jonathan U. Peled, Shuli Li, Jasmin Mahabamunuge, Zeina Dagher, Ann E. Slingerland, Candice Del Rio, Betsy Valles, Maria E. Kempner, Melissa Smith, Jami Brown, Bimalangshu R. Dey, Areej El-Jawahri, Steven L. McAfee, Thomas R. Spitzer, Karen K. Ballen, Anthony D. Sung, Tara E. Dalton, Julia A. Messina, Katja Dettmer, Gerhard Liebisch, Peter Oefner, Ying Taur, Eric G. Pamer, Ernst Holler, Michael K. Mansour, Marcel R. M. van den Brink, Elizabeth Hohmann, Robert R. Jenq, and Yi-Bin Chen BloodAdv Volume 2(7):745-753 April 10, 2018 © 2018 by The American Society of Hematology

Zachariah DeFilipp et al. Blood Adv 2018;2:745-753 © 2018 by The American Society of Hematology

Study schema. Study schema. Zachariah DeFilipp et al. Blood Adv 2018;2:745-753 © 2018 by The American Society of Hematology

Study flow diagram. Study flow diagram. IBD, inflammatory bowel disease. Zachariah DeFilipp et al. Blood Adv 2018;2:745-753 © 2018 by The American Society of Hematology

Longitudinal changes in urinary 3-IS levels before allo-HCT and after FMT administration in the early posttransplant period. Longitudinal changes in urinary 3-IS levels before allo-HCT and after FMT administration in the early posttransplant period. Zachariah DeFilipp et al. Blood Adv 2018;2:745-753 © 2018 by The American Society of Hematology

Evaluation of the microbiome prior to and following administration of FMT. Longitudinal changes in (A) inverse Simpson index, (B) Clostridiales abundance, and (C) UniFrac distance before allo-HCT and after FMT administration in the early posttransplant period, as determined from 16S rRNA sequencing of stool specimens. Evaluation of the microbiome prior to and following administration of FMT. Longitudinal changes in (A) inverse Simpson index, (B) Clostridiales abundance, and (C) UniFrac distance before allo-HCT and after FMT administration in the early posttransplant period, as determined from 16S rRNA sequencing of stool specimens. (D) Longitudinal changes in the origin of operational taxonomic units. Four selected patients shown. Zachariah DeFilipp et al. Blood Adv 2018;2:745-753 © 2018 by The American Society of Hematology

Microbiome assessment under conditions that highlight the potential benefit of FMT as part of an exploratory analysis in a subset of 8 patients. Microbiome assessment under conditions that highlight the potential benefit of FMT as part of an exploratory analysis in a subset of 8 patients. Eligibility criteria for inclusion in this subset analysis received microbiome-disrupting antibiotics (ceftazidime, cefepime, piperacillin-tazobactam, meropenem, oral vancomycin, or metronidazole) before FMT, and did not receive microbiome-disrupting antibiotics in the 60 days after FMT. Zachariah DeFilipp et al. Blood Adv 2018;2:745-753 © 2018 by The American Society of Hematology

Microbiome diversity after FMT compared with a post hoc comparison cohort of patients with allo-HCT who did not receive FMT. The inverse Simpson scores of 8 FMT recipients from Figure 5 are compared with those of patients who underwent allo-HCT at 2 other institutions and had stool specimens collected and 16S sequenced in a manner identical to those from FMT recipients. Microbiome diversity after FMT compared with a post hoc comparison cohort of patients with allo-HCT who did not receive FMT. The inverse Simpson scores of 8 FMT recipients from Figure 5 are compared with those of patients who underwent allo-HCT at 2 other institutions and had stool specimens collected and 16S sequenced in a manner identical to those from FMT recipients. Zachariah DeFilipp et al. Blood Adv 2018;2:745-753 © 2018 by The American Society of Hematology