Distinct effects of a dairy probiotic drink and physical exercise on gut microbiota in pediatric acute lymphoblastic leukemia patients in remission: a randomized clinical trial

Introduction: Treatment of pediatric acute lymphoblastic leukemia (ALL) induces persistent gut microbiota dysbiosis. However, microbiota-targeted interventions remain limited. This study evaluated the independent effects of physical exercise and probiotic supplementation on gut microbiota composition in pediatric ALL patients in remission for <5 years. Methods: Thirty patients were randomized to an experimental group (8-week exercise followed by 8-week daily probiotic intake) or a non-intervention control group. Gut microbiota composition, stool metabolite profiles, anthropometric parameters, and physical strength outcomes were assessed. Results: = 0.041), accompanied by increases in lactic acid bacteria (LAB) and short-chain fatty acid (SCFA)-producing taxa. Discussion: Overall, probiotic supplementation had a greater impact on gut microbiota composition than physical activity, inducing targeted shifts toward a more favorable microbial profile in this clinically vulnerable population.