TY - JOUR
T1 - Increased fecal primary bile acids in multiple myeloma with engraftment syndrome diarrhea after stem cell transplant
AU - Vijayvargiya, Priya
AU - Gonsalves, Wilson
AU - Burton, Duane
AU - Hogan, William J.
AU - Miceli, Teresa
AU - Rossini, William
AU - Taylor, Ann
AU - Lueke, Alan
AU - Donato, Leslie
AU - Camilleri, Michael
N1 - Publisher Copyright:
© 2019, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Autologous stem cell transplant (ASCT) for multiple myeloma (MM) is associated with diarrhea during the peri-transplant period. We aimed to appraise mechanisms of peri-ASCT diarrhea in a prospective, longitudinal study of patients with MM. We compared by repeated measures (RM)-ANOVA daily bowel movements (BMs) and consistency [7-point Bristol Stool Form Scale (BSFS)], fecal calprotectin (intestinal inflammation), 13C-mannitol excretion in urine 0–2 h (small intestinal permeability), fasting serum C4 (bile acid synthesis) and total and primary bile acid in stool samples during baseline, peri-transplant period (Days 5–7 after stem cell infusion), and after hematological recovery post-ASCT. The 12 (5F, 7M) patients’ median age was 61 y (IQR 54.8–63.3). All participants reported increased BMs (increase of 2 and 1 per day with and without engraftment syndrome, respectively). There were no significant increases in serum C4, total fecal bile acids, or intestinal permeability. Relative to patients without engraftment syndrome, four participants with engraftment syndrome had looser stool consistency (mean 2.6 points higher BSFS compared to without engraftment syndrome), increased primary fecal bile acids relative to baseline (>33 µmol/L vs. 6 µmol/L without engraftment syndrome), and increased fecal calprotectin compared to baseline (313 μg/mL vs. 35.6 μg/mL without engraftment syndrome; p = 0.06). Engraftment syndrome post-ASCT is associated with increased fecal primary bile acids.
AB - Autologous stem cell transplant (ASCT) for multiple myeloma (MM) is associated with diarrhea during the peri-transplant period. We aimed to appraise mechanisms of peri-ASCT diarrhea in a prospective, longitudinal study of patients with MM. We compared by repeated measures (RM)-ANOVA daily bowel movements (BMs) and consistency [7-point Bristol Stool Form Scale (BSFS)], fecal calprotectin (intestinal inflammation), 13C-mannitol excretion in urine 0–2 h (small intestinal permeability), fasting serum C4 (bile acid synthesis) and total and primary bile acid in stool samples during baseline, peri-transplant period (Days 5–7 after stem cell infusion), and after hematological recovery post-ASCT. The 12 (5F, 7M) patients’ median age was 61 y (IQR 54.8–63.3). All participants reported increased BMs (increase of 2 and 1 per day with and without engraftment syndrome, respectively). There were no significant increases in serum C4, total fecal bile acids, or intestinal permeability. Relative to patients without engraftment syndrome, four participants with engraftment syndrome had looser stool consistency (mean 2.6 points higher BSFS compared to without engraftment syndrome), increased primary fecal bile acids relative to baseline (>33 µmol/L vs. 6 µmol/L without engraftment syndrome), and increased fecal calprotectin compared to baseline (313 μg/mL vs. 35.6 μg/mL without engraftment syndrome; p = 0.06). Engraftment syndrome post-ASCT is associated with increased fecal primary bile acids.
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U2 - 10.1038/s41409-019-0581-6
DO - 10.1038/s41409-019-0581-6
M3 - Article
C2 - 31148601
AN - SCOPUS:85066813139
SN - 0268-3369
VL - 54
SP - 1898
EP - 1907
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 11
ER -