Australia is poised to undertake its first clinical trials using fecal transplants to treat blood cancer patients who develop serious complications after bone marrow transplants.
In graft-versus-host disease (GVHD), immune cells in the donor’s bone marrow (graft) attack the recipient’s (host) organs and tissues. GVHD can be particularly devastating to people who have had bone marrow transplants to treat cancer.
“Bone marrow transplantation can be a double-edged sword,” says Dr. Andrea Henden, clinical scientist at the QIMR Berghofer Medical Research Institute and physician at the Royal Brisbane and Women’s Hospital. “It saves lives for people with advanced blood cancers, but it can take lives by causing GVHD, which is heartbreaking.”
Patients who develop GVHD in the gut do not respond to conventional treatments.
“GVHD is particularly difficult to treat enterally in patients who are often hospitalized for long periods of time and who are dependent on hospital care and intensive immunosuppressive drugs,” said Henden. “Conventional immunosuppressive steroids are ineffective in half of all her GVHD patients.”
Studies have shown that the gut microbiome, or microbiota, is critical to maintaining good health. It stimulates the immune system, protects against invading pathogens, breaks down potentially toxic foods, and produces certain vitamins and amino acids.
Fecal Microbiota Transplantation (FMT), or as it is colloquially known, restores gut health by using fecal bacteria and other microbes from healthy individuals to repopulate the microbiome of unhealthy individuals. Enter the “poop transplant” that is designed to put back.
Like blood donors, microbiota donors are rigorously screened. Faecal donations are processed and tested at a facility approved by Therapeutic Goods Administration (TGA) prior to use. FMT has already proven to be very successful in treating intestinal infections.
“Emerging science shows that the microbiome has a greater impact on health than anyone could have ever imagined. We already know FMT can be life-changing, and we’ve had relapses.” It has a 90% success rate in treating different intestinal infections. Clostridioides difficile”
Now, for the first time in Australia, FMT will be trialed in blood cancer survivors diagnosed with GVHD. The study, led by Henden, will enroll 10 patients next year before proceeding to a larger trial.
Landmark clinical trials have led to the discovery of specific microbes responsible for ameliorating GVHD, with the goal of providing patients with easier, more targeted treatments in the future.
“FMT is a very exciting new approach that can save lives. We can treat GVHD in a safer way that maintains immunity.”
The trial also has the potential to reveal more effective treatments for conditions such as Crohn’s disease and ulcerative colitis, which share similar characteristics with GVHD.
The video below discusses the trial and how GVHD affects patients.
Pioneering ‘poop transplant’ trial gives hope to critically ill cancer patients
Source: QIMR Berghofer Medical Research Institute
