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Peer-reviewedCC BYFrontiers in pediatrics

Gut microbiota dysbiosis in pediatric acute lymphoblastic leukemia: clinical consequences, mechanistic insights, and microbiota-targeted interventions.

4 affiliations
  1. 1Department of Clinical Nutrition, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
  2. 2School of Chinese Medicine, Macau University of Science and Technology, Macau SAR, China.
  3. 3School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, United States.
  4. 4Department of Virtual Reality Technology, College of Digital Technology and Design, Chongqing Polytechnic University of Electronic Technology, Chongqing, China.

Abstract

Gut microbiota dysbiosis has emerged as a key feature in pediatric acute lymphoblastic leukemia (ALL), driven by chemotherapy, antibiotic exposure, and treatment-related nutritional impairment. Increasing evidence indicates that disruption of microbial diversity and depletion of short-chain fatty acid-producing bacteria are closely associated with infectious complications, gastrointestinal toxicity, and potentially reduced treatment efficacy. This review synthesizes current evidence on the interplay between gut microbiota and pediatric ALL across four dimensions: clinical outcomes, treatment-related toxicity, pharmacological interactions, and prognosis. We further summarize how leukemia therapy reshapes microbial ecosystems through cytotoxic agents, antimicrobial exposure, and dietary alterations. In addition, we discuss microbiota-centered therapeutic strategies, including probiotics, prebiotics, synbiotics, postbiotics, dietary interventions, and fecal microbiota transplantation. While promising, these approaches require careful validation in pediatric oncology due to safety considerations and limited clinical trial data. Finally, we highlight methodological advances such as multi-omics integration and machine learning approaches, which may enable microbiome-based risk stratification and precision supportive care in the future. Overall, gut microbiota represents a potential modifiable factor influencing clinical outcomes in pediatric ALL.

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BibTeX
@article{chen2026microbiota,
  title = {{Gut microbiota dysbiosis in pediatric acute lymphoblastic leukemia: clinical consequences, mechanistic insights, and microbiota-targeted interventions.}},
  author = {Ke Chen and Qingqing Li and Yun Xing and Changqi Liu and Fei Yang},
  journal = {Frontiers in pediatrics},
  year = {2026},
  month = oct,
  doi = {10.3389/fped.2026.1928304},
  url = {https://europepmc.org/article/MED/42903521},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Gut microbiota dysbiosis in pediatric acute lymphoblastic leukemia: clinical consequences, mechanistic insights, and microbiota-targeted interventions.
AU  - Ke Chen
AU  - Qingqing Li
AU  - Yun Xing
AU  - Changqi Liu
AU  - Fei Yang
PY  - 2026
DA  - 2026/10/06
JO  - Frontiers in pediatrics
DO  - 10.3389/fped.2026.1928304
UR  - https://europepmc.org/article/MED/42903521
AB  - Gut microbiota dysbiosis has emerged as a key feature in pediatric acute lymphoblastic leukemia (ALL), driven by chemotherapy, antibiotic exposure, and treatment-related nutritional impairment. Increasing evidence indicates that disruption of microbial diversity and depletion of short-chain fatty acid-producing bacteria are closely associated with infectious complications, gastrointestinal toxicity, and potentially reduced treatment efficacy. This review synthesizes current evidence on the interplay between gut microbiota and pediatric ALL across four dimensions: clinical outcomes, treatment-related toxicity, pharmacological interactions, and prognosis. We further summarize how leukemia therapy reshapes microbial ecosystems through cytotoxic agents, antimicrobial exposure, and dietary alterations. In addition, we discuss microbiota-centered therapeutic strategies, including probiotics, prebiotics, synbiotics, postbiotics, dietary interventions, and fecal microbiota transplantation. While promising, these approaches require careful validation in pediatric oncology due to safety considerations and limited clinical trial data. Finally, we highlight methodological advances such as multi-omics integration and machine learning approaches, which may enable microbiome-based risk stratification and precision supportive care in the future. Overall, gut microbiota represents a potential modifiable factor influencing clinical outcomes in pediatric ALL.
SN  - 2296-2360
ER  -