Autologous faecal microbiota transfer safe, effective for AML patients under intensive chemo
06 Jun 2021
The composition of gut microbiota is critical not only for regulating the immune system, but also for maintaining mental health and combating extrinsic pathogens.Autologous faecal microbiota transfer (AFMT) appears to be a safe procedure in acute myeloid leukaemia (AML) patients undergoing intensive chemotherapy, and seems to effectively restore gut microbiota, a recent study has found.
Twenty-five AML patients (median age 52 years, 72 percent men) were enrolled, all of whom were receiving intensive chemotherapy along with antibiotics, and underwent AFMT. The main outcomes of interest were the efficacy of AFMT at correcting dysbiosis and at eliminating multidrug-resistant bacteria (MDRB). A control group of 20 AML patients (median age 50 years, 75 percent men) with no AFMT was also included.
In all patients, intensive chemotherapy induced a significant and dramatic reduction in gut microbiota richness and diversity, both at the cellular and genetic level. After AFMT treatment, α-diversity indices returned to their initial median levels, representing a significant increase as compared to the time under chemotherapy. Genetic diversity likewise increased with AFMT but did not return to baseline levels.
Similarly, MDRB colonization spiked during intensive chemotherapy, followed by a significant drop after AFMT, indicating that the microbiota transfer procedure could help eliminate MDRB.
In terms of safety, the researchers detected no harmful changes in vital signs during AFMT treatment. Five adverse events (AEs) occurred in four patients during the first 24 hours of the procedure. Two were deemed related to AFMT but needed no treatment and were eventually resolved without sequelae. No serious AEs were reported.
Over the next year, 415 AEs were reported, most of which were in line with leukaemia profiles after undergoing intensive chemotherapy.
“AFMT appears to be safe and effective for gut microbiota restoration in patients receiving induction chemotherapy and antibiotic for AML,” the researchers said. “Besides this particular setting, providing patients with a drug that may modulate inflammation and better potentiate other anticancer treatments is of considerable interest.”