Role of the gut microbiome in the development and prognosis of pediatric leukemia

Table 2 Emerging interventions in pediatric leukemia

Intervention	Agent	Clinical implications	Ref.
Lactoferrin	Bovine lactoferrin 200 mg/day	Prevents dysbiosis; reduced febrile neutropenia	Martyniak et al[20], 2023
Melatonin	Melatonin (various)	Increased microbiome diversity	Martyniak et al[20], 2023
Biomarkers	Quantitative polymerase chain reaction (Ruminococcaceae/Veillonella)	91% specificity for neutropenia risk	Sørum et al[9], 2025
VOC panel	Fecal VOC profiling	Predicts bloodstream infection 15 days pre-symptoms	van de Velde et al[4], 2022
Autologous fecal microbiome transplantation	Patient’s own stool	Personalized microbiome recovery	Todor and Ichim[8], 2025
Lactose-free diet	Conditioning/hematopoietic stem cell transplantation	Prevents Enterococcus blooms; reduced graft-versus-host disease	Muratore et al[19], 2022
High-fiber diet	≥ 5 g fiber/day	27% reduced leukemia risk (epidemiological)	Kameri et al[10], 2024

VOC: Volatile organic compound.