Bologna, Italy – A new multi-center investigation has uncovered significant differences in the gut microbiome of children newly diagnosed with acute lymphoblastic leukemia (ALL), the most common childhood cancer. Using high-resolution shotgun metagenomic sequencing, researchers analyzed stool samples from 30 pediatric ALL patients across Italy and compared them with 176 healthy controls from European cohorts. The findings highlight a clear microbial imbalance at diagnosis, offering new insights into the disease’s early development.
The study reports that children with ALL show a distinct microbial profile characterized by elevated levels of Enterococcus faecium, several oral-derived species such as Rothia dentocariosa, and multiple opportunistic pathogens. In contrast, healthy children demonstrated higher levels of beneficial short-chain–fatty-acid–producing bacteria, including Anaerostipes hadrus and Intestinibacter bartlettii. These microbes support gut health, immune regulation, and metabolic balance.
Functional analyses further revealed that the ALL-associated microbiome favored protein and amino acid breakdown, whereas healthy controls showed enhanced carbohydrate and folate metabolism—patterns consistent with a more stable and nutritionally supportive gut ecosystem.
Importantly, the study found minimal differences between the microbiomes of children with B-cell ALL and T-cell ALL, suggesting that dysbiosis is a broader feature of the disease rather than subtype-specific.
Conducted within the AIEOP pediatric oncology network, the study leveraged advanced sequencing and standardized bioinformatics workflows to ensure rigorous comparisons across patient and control samples. According to the researchers, these results reinforce the hypothesis that early-life disruptions in gut microbiome development may contribute to the multistep pathogenesis of ALL.
The authors note that further research is needed to determine whether these microbial signatures play a causal role in leukemia development or serve as early biomarkers for disease risk.
Expert Contacts
Dr. Edoardo Muratore – University of Bologna
Gabriele Conti – University of Bologna