A new study published in Nature Communications shows that oral faecal microbiota transplantation (FMT) is a safe addition to preventing graft-versus-host disease in patients undergoing stem cell transplantation for blood cancers. FMT is a holistic microbiota restoration approach that can be performed as a precision medicine therapeutic.
This research is part of a phase 2 clinical trial led by Armin Rashidi, MD, PhD, a medical oncologist at Fred Hutch.
The randomized phase of the trial will study whether FMT improves health outcomes for patients undergoing stem cell transplantation, such as less acute graft-versus-host disease, fewer hospitalizations, fewer infections, better quality of life and longer survival.
In terms of detail, the study was composed of twenty patients who underwent allogeneic stem cell transplantations for various blood disorders including blood cancers. Teach patient then received FMT via oral capsules, to be taken three times a day for seven days
In a statement, Rashidi observes: “The gut microbiome is an organ in itself, and it is connected to the immune system.”
He adds: “Since the process of stem cell transplantation damages the gut microbiome, we want to see if FMT will help restore microbial diversity and promote the beneficial bacterial species that support a healthy immune system.”
The study produced some interesting outcomes:
Donor Differences Matter
The trial analysed three different FMT donors and found notable differences in how well each one established itself in the recipient. The optimal donor was characterized by high levels of Bifidobacterium adolescentis, a beneficial microbe.
Microbiota Diversity Influences Success
Consistent with prior research, the study found that lower pre-FMT microbiota diversity in patients was associated with better donor microbiota engraftment. This suggests that less diverse pre-FMT gut environments may make it easier for transplanted microbes to establish themselves.
FMT is Safe
FMT was shown to be safe even in highly immunocompromised patients. The transfer of millions of live microbes to the patient did not cause any infections, likely because they were “healthy” microbes from a healthy donor.
Other clinical trials investigating FMT focus on treatments for autism, colitis, inflammatory bowel disease, and irritable bowel syndrome.
An important factor with microbiota engraftment appears to be where there is larger microbiota compositional shifts correlate towards the donor,, then the greater the chance of better clinical outcomes.
The research paper is titled “Fecal microbiota transplantation to prevent acute graft-versus-host disease: pre-planned interim analysis of donor effect.”
