Diagnostic value of intestinal tissue metagenomic next-generation sequencing in severe diarrhea following haploidentical hematopoietic stem cell transplantation
10.3760/cma.j.cn121090-20241206-00540
- VernacularTitle:肠道组织宏基因组二代测序技术在单倍体造血干细胞移植后严重腹泻患者中的诊断价值
- Author:
Qiaoxian LIN
1
;
Jingjing WEI
;
Tingting LIAN
;
Biqing LIN
;
Jinhua REN
;
Xiaoyun ZHENG
;
Xueqiong WU
;
Jing LI
;
Han CHEN
;
Shujian XIE
;
Ting YANG
Author Information
1. 福建医科大学附属第一医院滨海院区国家区域医疗中心血液科二科，福州 350212
- Publication Type:Journal Article
- Keywords:
Allogeneic hematopoietic stem cell transplantation;
Severe diarrhea;
Molecular diagnosis;
Metagenomics next generation sequencing Technology;
Infectious P
- From:
Chinese Journal of Hematology
2025;46(11):1020-1025
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the diagnostic value of intestinal tissue metagenomic next-generation sequencing (mNGS) in severe diarrhea following haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:Sixteen patients who developed severe diarrhea or hematochezia after haploidentical allo-HSCT at the First Affiliated Hospital of Fujian Medical University (June 2023–August 2024) were enrolled. All underwent gastrointestinal endoscopy and mNGS for microbial detection. Clinical, endoscopic, pathological, and microbiological data were analyzed to evaluate the diagnostic value of mNGS and treatment outcomes following targeted therapy.Results:The study included 16 patients (12 males, 4 females; median age 32.5 years, range 3–60 years). Diarrhea occurred a median of 3.93 months post-transplant (range 1.63–10.40 months). Stool cultures were negative except for one case with Candida. One patient tested positive for Clostridium difficile antigen. Endoscopy revealed mucosal congestion, edema, erosion, and bleeding, with focal inflammation on pathology. mNGS detected pathogens in 87.5% (14/16) of cases, including mixed infections in 78.5% (11/14). Common pathogens were Klebsiella pneumoniae, Enterococcus faecium, Escherichia coli, Rhizopus microsporus, EBV, and CMV. Targeted treatment adjustments led to symptom improvement in 87.5% of patients.Conclusion:Allo-HSCT patients are prone to infectious diarrhea due to immunosuppression. Molecular analysis of endoscopic biopsy tissues using mNGS can accurately identify pathogens, guide targeted therapy, and improve clinical outcomes.
