Gut Health & Myeloma: How Bacteria May Predict Transplant Success With Pooja Phull, MD

In this special edition of Treating Together, Pooja Phull, MD, hematologist-oncologist at the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey discusses a study investigating the relationship between the gut microbiome, specifically butyrate-producing bacteria, and progression-free survival (PFS) in patients with multiple myeloma (MM) undergoing autologous stem cell transplantation (ASCT).

Researchers analyzed stool samples from 64 patients at 3 intervals: pre-ASCT, during engraftment, and 2 to 4 months post transplant.

The study identified a significant decline in butyrate-producing bacteria during the engraftment phase compared to pretransplant levels. This depletion was clinically significant, as the loss of these producers at engraftment was associated with inferior PFS. Conversely, a higher abundance of specific butyrate-producing taxa, such as Petrocella atlantisensis (HR, 0.71), predicted improved outcomes.

The authors conclude that the gut microbiome serves as a prognostic indicator for MM progression that is independent of traditional clinical markers. The depletion of butyrate producers during the critical engraftment window is a key predictor of relapse. These findings suggest that the microbiome could be a novel actionable biomarker and that postbiotic supplements such as butyrate may serve as effective adjuvants to improve posttransplant treatment responses.