Investigation of the Gut Microbiota in Patients With Acute Myeloid Leukemia

Université Catholique de Louvain60 enrolled

Overview

This cohort study aims to investigate the composition and activity of the gut microbiota of patients newly diagnosed for acute myeloid leukemia (AML), in relationship with their food habits and cachectic hallmarks. The recruitment for this study is currently ongoing with the help of clinicians, nurses and data managers at the Saint-Luc clinics, University Hospital Leuven (Campus Gasthuisberg) and University Hospital Gent. Primary Objective •To assess the composition and activity of the gut microbiota in patients with acute myeloid leukemia (AML) compared to matched control subjects. Secondary Objectives * To investigate correlations between the gut microbiota, cachectic hallmarks and gut microbiota-related markers in the blood (gut permeability markers, microbial compounds, microbial metabolites). * To characterize the changes in the gut microbial ecosystem that are induced by chemotherapy and associated with colitis. * To assess whether the composition of the gut microbiota can predict the severity of chemotherapy-related colitis. Study Design This is an academic multi-centric prospective study. The study is composed of two cohorts (Fig. 1). In Cohort A, patients are included before any chemotherapy. Biological samples (urine, feces, blood) are collected, alongside information on nutritional habits, appetite and medical records. Muscle strength and body composition are also measured. Only patients receiving a standard chemotherapy are included in Cohort B. In Cohort B, biological samples are collected and body composition, muscle strength and appetite are evaluated at 2 different time points, at the end of the chemotherapy (T1) and at discharge (T4).

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

NONE

Enrollment

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with * A diagnosis of AML and related precursor neoplasms according to WHO 2008 classification (excluding acute promyelocytic leukemia) including secondary AML (after an antecedent hematological disease (e.g. MDS) and therapy-related AML) * Acute leukemia's of ambiguous lineage according to WHO 2008 * A diagnosis of refractory anemia with excess of blasts (MDS REAB) 2 and IPSS (International Prognostic Scoring System)-R score \> 2. * World Health Organization performance status 0, 1 or 2 * Sampled bone marrow and/ blood cells at diagnosis with molecular analysis. * Written informed consent * Good command of the French or Dutch language Exclusion Criteria: * Age \< 18 years * Age \> 75 years * Pregnancy * Antibiotics consumption during the last 30 days before inclusion * Recent chemotherapy (\< 3 months), with exclusion of hydroxyurea * BMI \>30 * Any history of chronic intestinal affections (Crohn disease, inflammatory bowel disease, gluten intolerance) * Gastric bypass * Current treatment with antidiabetic or hypoglycemic drugs

Outcomes

Primary Outcomes

Description of gut microbiota composition in patients with acute myeloid leukemia and control subjects

Sequencing DNA extracts from patients' feces (both patients with acute myeloid leukemia and control subjects matched for BMI, sex and age) to obtain the description of gut microbiota composition in those patients

Time frame: Day 0 i.e.: feces sampling is done at time of diagnosis before any chemotherapy

Measure of metabolites production by the gut microbiota in patients with acute myeloid leukemia and control subjects

1H-NMR metabolomics performed on patients' feces (both patients with acute myeloid leukemia and control subjects matched for BMI, sex and age) to report the metabolites produced by the gut microbiota of those patients

Time frame: Day 0 i.e.: feces sampling is done at time of diagnosis before any chemotherapy