Study Using Prebiotics to Improve Gut Microbiome Diversity After Autologous Cellular Therapy

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age19+
SponsorUniversity of Nebraska

About this trial

Higher gut microbiome diversity has been associated with improved survival following autologous stem cell transplantation in multiple myeloma and lymphoma. This study hypothesises that prebiotic supplementation with resistant starch (RS) will improve gut microbiome diversity at time of stem cell engraftment. To test this, participants will either have RS or a placebo (maltodextrin) mixed into a food item of their choice for approximately 10 days prior to stem cell infusion and continue to the first day of neutrophil engraftment. The study will look at the difference in gut microbiome diversity between the RS and placebo arm collected at the engraftment timepoint, dietary evaluation to assess the impact of subject diet on microbiome response to intervention and serum sample collection to assess differences to gut permeability during transplant.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Willing to provide informed consent

Willing to comply with all study procedures and be available for the duration of the study

Has pathologically confirmed multiple myeloma, Non-Hodgkin lymphoma (DLBCL, mantle cell lymphoma, follicular lymphoma, or peripheral T-cell lymphoma), or Hodgkin lymphoma as determined on medical record review per standard of care transplant procedures (no tissue required for study)

Meeting a standard-of-care indication for autologous stem cell transplantation for the above diseases as determined by the investigator

Disqualifiers

History of bariatric surgery (i.e. gastric banding, sleeve gastrectomy, Roux-en-Y bypass), chronic gastrointestinal disease including chronic diarrheal illness or inflammatory bowel disease

Previous intolerance to fiber supplementation

Allergy or intolerance to potato starch or maltodextrin

Subject unwilling to comply with stool sample collection

Trial design

Design model

Parallel

Treatments tested in this trial

  • Resistant Starch

    Dietary supplement

    A prebiotic nutritional supplement available at commercial grocery and health food stores. Specifically, we will be using Bob's Red Mill® potato starch.

  • Maltodextrin

    Dietary supplement

    A starch commonly used as a placebo in prebiotic trials that is digested in the stomach and rapidly absorbed

Treatment groups

30 Participants
are divided into 2 treatment groups
Group A: TreatmentExperimental treatment 1 intervention
Group B: PlaceboPlacebo comparator 1 intervention

Trial outcomes

Primary outcomes

1

Percentage of subjects who adhere to >70% of scheduled doses of the intervention

To understand the feasibility of the intervention in the proposed study population, the percentage of subjects who adhere to \>70% of scheduled doses will be calculated

Time frame
35 Days

Secondary outcomes

1

Hospital Duration

To evaluate the duration of hospitalization according to intervention assignment by measuring time from stem cell transplant to day of discharge.

Time frame
25 days
2

Rate of Neutropenic Fever

To estimate the rate of neutropenic fever in the post-transplant setting according to intervention assignment. This is captured by cumulative incidence of neutropenic fever (ANC \<1000, temperature \>38.0⁰C) by day 30 according to intervention assignment

Time frame
25 Days
3

Rate of broad-spectrum antibiotic exposure

To determine the rate of broad-spectrum antibiotic exposure during transplant according to intervention assignment by measuring the proportion of subjects receiving systemic antibiotic exposure.

Time frame
25 Days
4

Rate of gastrointestinal symptoms

To determine the rate of gastrointestinal symptoms according to intervention assignment by using the patient-reported gastrointestinal symptom rating scale (GSRS.)

Time frame
35 Days

Other outcomes

Sponsors and contacts

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