Faecal microbiota transplantation to prevent complications after allogeneic stem cell transplantation for haematological malignancies: a study protocol for a randomised controlled phase-II trial (the FMT-allo study)
Introduction Allogeneic haematopoietic stem-cell transplantation (allo-HSCT) is a major treatment for many haematological malignancies. The procedure has a good success rate but high transplant-related toxicity (TRM). TRM is mostly related to graft-versus-host disease (GvHD) and infectious complicat...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/5/e068480.full |
| _version_ | 1797834348837208064 |
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| author | Harry Sokol Bruno Pereira Stephanie Nguyen Jacques-olivier Bay Aurore Dougé Aurélie Ravinet Alexandrine Corriger Aurélie Cabrespine Mathieu Wasiak |
| author_facet | Harry Sokol Bruno Pereira Stephanie Nguyen Jacques-olivier Bay Aurore Dougé Aurélie Ravinet Alexandrine Corriger Aurélie Cabrespine Mathieu Wasiak |
| author_sort | Harry Sokol |
| collection | DOAJ |
| description | Introduction Allogeneic haematopoietic stem-cell transplantation (allo-HSCT) is a major treatment for many haematological malignancies. The procedure has a good success rate but high transplant-related toxicity (TRM). TRM is mostly related to graft-versus-host disease (GvHD) and infectious complications. Alterations of the intestinal microbiota plays a major role in the development of allo-HSCT complications. The gut microbiota could be restored by faecal microbiota transplantation (FMT). However, there are no published randomised studies assessing the efficacy of FMT for GvHD prophylaxis.Methods and analysis This prospective, open-label, multi-centre, parallel-group, randomised phase-II clinical trial has been designed to assess the effect of FMT on toxicity in patients treated with myeloablative allo-HSCT for haematological malignancy. Based on Fleming’s single-stage sample size estimation procedure, the design plans to include 60 male and female patients aged 18 or over per arm, to be randomly assigned to two groups, one with and one without (control group) FMT. The primary endpoint is GvHD-free relapse-free survival rate at 1 year after allo-HSCT. Secondary endpoints are outcome measures of the impact of FMT on allo-HSCT-related morbidity and mortality (overall survival and progression-free survival at 1 and 2 years, haematological parameters, infectious complications, tolerance and safety of FMT). The primary endpoint will be evaluated according to assumptions of the single-stage Fleming design, compared between groups by a log-rank test and further investigated in a multivariate marginal structural Cox model taking into account centre effect. The proportional-hazard hypothesis will be verified using Schoenfeld’s test and by plotting residuals.Ethics and dissemination The local institutional review board (CPP Sud-Est II, France) issued approval on 27 January 2021. The French national authorities issued approval on 15 April 2021. The outcome of the study will be disseminated via peer-reviewed publications and at congresses.Trial registration number NCT04935684. |
| first_indexed | 2024-04-09T14:37:55Z |
| format | Article |
| id | doaj.art-5fe08b61971b43f7a3adf9531c0d4a62 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-09T14:37:55Z |
| publishDate | 2023-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-5fe08b61971b43f7a3adf9531c0d4a622023-05-03T11:30:07ZengBMJ Publishing GroupBMJ Open2044-60552023-05-0113510.1136/bmjopen-2022-068480Faecal microbiota transplantation to prevent complications after allogeneic stem cell transplantation for haematological malignancies: a study protocol for a randomised controlled phase-II trial (the FMT-allo study)Harry Sokol0Bruno Pereira1Stephanie Nguyen2Jacques-olivier Bay3Aurore Dougé4Aurélie Ravinet5Alexandrine Corriger6Aurélie Cabrespine7Mathieu Wasiak815Saint Antoine hospital, Paris, France2 DRCI Biostatistical department, University Hospital, Clermont-Ferrand, France13 Hematology Department, Montpellier University Hospital, Montpellier, FranceService de Thérapie Cellulaire et d’Hématologie Clinique Adulte, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, FranceService d`Oncologie Médicale, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, FranceService de Thérapie Cellulaire et d’Hématologie Clinique Adulte, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, FranceService de Thérapie Cellulaire et d’Hématologie Clinique Adulte, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, FranceSecteur Biométrie et Médico-économie, Direction de la Recherche Clinique et de l’Innovation, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, FrancePôle Pharmacie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, FranceIntroduction Allogeneic haematopoietic stem-cell transplantation (allo-HSCT) is a major treatment for many haematological malignancies. The procedure has a good success rate but high transplant-related toxicity (TRM). TRM is mostly related to graft-versus-host disease (GvHD) and infectious complications. Alterations of the intestinal microbiota plays a major role in the development of allo-HSCT complications. The gut microbiota could be restored by faecal microbiota transplantation (FMT). However, there are no published randomised studies assessing the efficacy of FMT for GvHD prophylaxis.Methods and analysis This prospective, open-label, multi-centre, parallel-group, randomised phase-II clinical trial has been designed to assess the effect of FMT on toxicity in patients treated with myeloablative allo-HSCT for haematological malignancy. Based on Fleming’s single-stage sample size estimation procedure, the design plans to include 60 male and female patients aged 18 or over per arm, to be randomly assigned to two groups, one with and one without (control group) FMT. The primary endpoint is GvHD-free relapse-free survival rate at 1 year after allo-HSCT. Secondary endpoints are outcome measures of the impact of FMT on allo-HSCT-related morbidity and mortality (overall survival and progression-free survival at 1 and 2 years, haematological parameters, infectious complications, tolerance and safety of FMT). The primary endpoint will be evaluated according to assumptions of the single-stage Fleming design, compared between groups by a log-rank test and further investigated in a multivariate marginal structural Cox model taking into account centre effect. The proportional-hazard hypothesis will be verified using Schoenfeld’s test and by plotting residuals.Ethics and dissemination The local institutional review board (CPP Sud-Est II, France) issued approval on 27 January 2021. The French national authorities issued approval on 15 April 2021. The outcome of the study will be disseminated via peer-reviewed publications and at congresses.Trial registration number NCT04935684.https://bmjopen.bmj.com/content/13/5/e068480.full |
| spellingShingle | Harry Sokol Bruno Pereira Stephanie Nguyen Jacques-olivier Bay Aurore Dougé Aurélie Ravinet Alexandrine Corriger Aurélie Cabrespine Mathieu Wasiak Faecal microbiota transplantation to prevent complications after allogeneic stem cell transplantation for haematological malignancies: a study protocol for a randomised controlled phase-II trial (the FMT-allo study) BMJ Open |
| title | Faecal microbiota transplantation to prevent complications after allogeneic stem cell transplantation for haematological malignancies: a study protocol for a randomised controlled phase-II trial (the FMT-allo study) |
| title_full | Faecal microbiota transplantation to prevent complications after allogeneic stem cell transplantation for haematological malignancies: a study protocol for a randomised controlled phase-II trial (the FMT-allo study) |
| title_fullStr | Faecal microbiota transplantation to prevent complications after allogeneic stem cell transplantation for haematological malignancies: a study protocol for a randomised controlled phase-II trial (the FMT-allo study) |
| title_full_unstemmed | Faecal microbiota transplantation to prevent complications after allogeneic stem cell transplantation for haematological malignancies: a study protocol for a randomised controlled phase-II trial (the FMT-allo study) |
| title_short | Faecal microbiota transplantation to prevent complications after allogeneic stem cell transplantation for haematological malignancies: a study protocol for a randomised controlled phase-II trial (the FMT-allo study) |
| title_sort | faecal microbiota transplantation to prevent complications after allogeneic stem cell transplantation for haematological malignancies a study protocol for a randomised controlled phase ii trial the fmt allo study |
| url | https://bmjopen.bmj.com/content/13/5/e068480.full |
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