Perturbation of the gut microbiome and association with outcomes following autologous stem cell transplantation in patients with multiple myeloma

Abstract

The gut microbiome is an important feature of host immunity with associations to hematologic malignancies and cellular therapy. We evaluated the gut microbiome and dietary intake in patients with multiple myeloma undergoing autologous stem cell transplantation. Thirty patients were enrolled, and samples were collected at four timepoints: pre-transplant, engraftment, day +100 (D + 100), and 9–12 months post-transplant. Microbiome analysis demonstrated a loss of alpha diversity at the engraftment timepoint driven by decreases in Blautia, Ruminococcus, and Faecalibacterium genera and related to intravenous antibiotic exposure. Higher fiber intake was associated with increased relative abundance of Blautia at the pre-transplant timepoint. Lower alpha diversity at engraftment was associated with a partial response to therapy compared with complete response (CR) or very good partial response (VGPR) (CR/VGPR vs. PR, p < 0.05). We conclude that loss of bacterial diversity at engraftment may be associated with impaired response to stem cell transplantation in multiple myeloma.

Keywords:

• Microbiome
• antibiotics
• nutrition
• multiple myeloma
• autologous stem cell transplant

Acknowledgements

The authors thank the patients and their families for participating in this research project. The authors also thank the members of the Safdar lab including Ashley Kates, Lauren Watson, Nathan Putnam Buehler, Jared Godfrey, and Courtney Deblois for all their efforts in helping with sample collection and microbiome sequencing.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Data are available on request to the corresponding author.

Additional information

Funding

Dr.D’Angelo was supported by a T32 training grant through the National Heart, Lung, and Blood Institute (5T32HL007899-20) and by a NIH loan repayment award through the National Cancer Institute (NCI). This work was additionally supported through a NIH/NCI 1R01CA252937-01 award to Dr. Asimakopoulos.