Acute Myeloid Leukemia, Cachexia
Conditions
Brief summary
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).
Interventions
OTHERcollection of clinical data and biological samples
* nutritional assessement * cachexia symptoms * urine, feces and blood samples
Sponsors
European Society for Clinical Nutrition and Metabolism
Université Catholique de Louvain
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Description of gut microbiota composition in patients with acute myeloid leukemia and control subjects | Day 0 i.e.: feces sampling is done at time of diagnosis before any chemotherapy | 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 |
| Measure of metabolites production by the gut microbiota in patients with acute myeloid leukemia and control subjects | Day 0 i.e.: feces sampling is done at time of diagnosis before any chemotherapy | 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 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in appetite | at day 0 (i.e.: feces sampling is done at time of diagnosis before any chemotherapy); | Measure of appetite with the SNAQ questionnaire (score from 5 to 20) |
| Changes in gut microbiota-related markers in the blood (gut permeability markers and microbial compounds) | at day 0 (i.e.: feces sampling is done at time of diagnosis before any chemotherapy); | ELISA (in pg/ml) |
| Changes in gut microbiota-related markers in the blood (microbial metabolites) | at day 0 (i.e.: feces sampling is done at time of diagnosis before any chemotherapy); | 1H-NMR metabolomics |
| Changes in muscle strength | at day 0 (i.e.: feces sampling is done at time of diagnosis before any chemotherapy); | Measure of muscle strength with Jamar dynamometer (in kg) |
| Changes in gut microbiota composition in patients with acute myeloid leukemia before, during and after chemotherapy | at day 0 (i.e.: feces sampling is done at time of diagnosis before any chemotherapy); | Sequencing DNA extracts from patients' feces to obtain the description of gut microbiota composition in those patients. |
| Changes in metabolites production by the gut microbiota in patients with acute myeloid leukemia before, during and after chemotherapy. | at day 0 (i.e.: feces sampling is done at time of diagnosis before any chemotherapy); | 1H-NMR metabolomics performed on patients' feces to report the metabolites produced by the gut microbiota of those patients. |
| Changes in number of participants with treatment related-related adverse events as assessed by CTCAE v4.0 | at day 0 (i.e.: feces sampling is done at time of diagnosis before any chemotherapy); | CTCAE (common terminology criteria for adverse event version 4) |
| Changes in gut microbiota-related markers in urine (gut permeability markers, microbial compounds, microbial metabolites) | at day 0 (i.e.: feces sampling is done at time of diagnosis before any chemotherapy); | ELISA and 1H-NMR metabolomics |
| Changes in body composition | at day 0 (i.e.: feces sampling is done at time of diagnosis before any chemotherapy); | Measure of body composition by bio-electric impedance (in kg) |
Countries
Belgium
Outcome results
None listed