Increased fecal primary bile acids in multiple myeloma with engraftment syndrome diarrhea after stem cell transplant

Priya Vijayvargiya, Wilson Gonsalves, Duane Burton, William Hogan, Teresa Miceli, William Rossini, Ann Taylor, Alan Lueke, Leslie Donato, Michael Camilleri

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalBone Marrow Transplantation
DOIs
StatePublished - Jan 1 2019

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Bile Acids and Salts
Multiple Myeloma
Diarrhea
Stem Cells
Transplants
Leukocyte L1 Antigen Complex
Permeability
Mannitol
Serum
Longitudinal Studies
Fasting
Analysis of Variance
Urine
Prospective Studies
Inflammation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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Increased fecal primary bile acids in multiple myeloma with engraftment syndrome diarrhea after stem cell transplant. / Vijayvargiya, Priya; Gonsalves, Wilson; Burton, Duane; Hogan, William; Miceli, Teresa; Rossini, William; Taylor, Ann; Lueke, Alan; Donato, Leslie; Camilleri, Michael.

In: Bone Marrow Transplantation, 01.01.2019.

Research output: Contribution to journalArticle

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AU - Gonsalves, Wilson

AU - Burton, Duane

AU - Hogan, William

AU - Miceli, Teresa

AU - Rossini, William

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AU - Lueke, Alan

AU - Donato, Leslie

AU - Camilleri, Michael

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