Abstract / Summary
Relying on the gut-bone marrow bidirectional regulatory axis, the gut microbiota regulates systemic immune homeostasis and the bone marrow hematopoietic microenvironment through signaling molecules such as maintenance of the mucosal barrier, short-chain fatty acids, and tryptophan metabolites, thereby deeply participating in the entire evolution of hematological malignancies. Patients with hematological malignancies universally exhibit characteristic dysbiosis, including decreased gut microbial diversity, depletion of butyrate-producing beneficial bacteria, and overproliferation of opportunistic pathogens. This dysbiosis can drive the origin of malignant hematopoietic clones and disease progression, regulate the response efficiency of chemotherapy and cellular therapy, and determine the risk of fatal complications such as graft-versus-host disease, severe infections, and intestinal mucositis following allogeneic hematopoietic stem cell transplantation. This article systematically reviews the interaction mechanisms between the gut microbiota and hematological malignancies, disease-specific microbiota profiles, therapeutic regulation rules, and bottlenecks in clinical translation, providing a theoretical basis for personalized microbiota-targeted therapy in hematological malignancies.