Gut Microbiome Suffers from Hematopoietic Stem Cell Transplantation in Childhood and Its Characteristics Are Positively Associated with Intra-Hospital Physical Exercise

SIMPLE SUMMARY: Gut microbiome research has rapidly advanced with good perspectives for the diagnostics and/or therapy of a plethora of diseases, including metabolic and neurodegenerative diseases and various types of cancer. In this study, we examined the composition of the fecal microbiota of eligible children with acute lymphoblastic leukemia (ALL) after hematopoietic stem cell transplantation (HSCT). We found a negative effect of HSCT treatment on microbiome bacterial diversity and richness with microbial monodominance by pathogenic bacteria in pediatric ALL patients after 3 months. The changes in the gut microbiota were associated with systemic inflammation on day + 28. However, promisingly, we have observed an association between bacterial diversity and physical exercise during HSCT treatment. Our findings provide additional support for the importance of investigating the gut microbiome in children with cancer. ABSTRACT: Gut microbiome impairment is a serious side effect of cancer treatment. The aim of this study was to identify the effects of hematopoietic stem cell transplantation (HSCT) treatment on gut microbiota composition in children with acute lymphoblastic leukemia (ALL). Fecal microbiotas were categorized using specific primers targeting the V1–V3 region of 16S rDNA in eligible pediatric ALL patients after HSCT (n = 16) and in healthy controls (Ctrl, n = 13). An intra-hospital exercise program was also organized for child patients during HSCT treatment. Significant differences in gut microbiota composition were observed between ALL HSCT and Ctrl with further negative effects. Plasma C-reactive protein correlated positively with the pathogenic bacteria Enterococcus spp. and negatively with beneficial bacteria Butyriccocus spp. or Akkermansia spp., respectively (rs = 0.511, p = 0.05; rs = −0.541, p = 0.04; rs = −0.738, p = 0.02). Bacterial alpha diversity correlated with the exercise training characteristics. Therefore, specific changes in the microbiota of children were associated with systemic inflammation or the ability to exercise physically during HSCT treatment.