Pathogenesis and Consequences of a Disruption to the Intestinal Barrier Functions in Patients with Hematologic Malignancies

The intestinal barrier is a complex structure that plays a pivotal role in the regulation of the influx of luminal contents into the systemic circulation and maintains homeostasis of immune cells, microbes, and metabolites. Disruption in the intestinal barrier functions has been implicated in the development of many systemic diseases such as nonalcoholic steatohepatitis, inflammatory bowel disease, multiple sclerosis, atherosclerosis, type 2 diabetes mellitus, and cancer. Therefore, the intestinal barrier presents a potential target for therapeutic intervention to alter the course and mitigate complications associated with these diseases. Patients with hematologic malignancies are particularly at high risk for developing a disruption to the intestinal barrier functions due to the disease processes and to therapeutic interventions, either to treat the underlying disease or to support the patient following treatment. In this chapter, we not only discuss the pathogenesis and nature of the intestinal barrier function disruption in patients with hematologic malignancies but also examine the associated complications. We explore methods available to modulate the complications and their associated challenges.