This is a single site pilot trial will evaluate the feasibility and safety of fecal microbiota transplantation (FMT) in patients with B-cell lymphoma who are undergoing CAR-T or in patients with moderate to high-risk acute myeloid leukemia or myelodysplastic syndrome who are undergoing allogeneic stem cell transplantation.
Men and women ≥ 18 years of age
Indolent or aggressive B-cell lymphoma eligible for standard or care CAR-T therapy (Cohort A), or
Patients with AML or high risk MDS with indication to undergo reduced-intensity conditioning alloSCT, with an available matched related, unrelated, or haploidentical donor (Cohort B)
ECOG 0-1
For patients undergoing alloSCT (Cohort B): plan to undergo myeloablative conditioning
Use of investigational agents within the last 4 weeks before enrollment.
Active or uncontrolled infection
Autoimmune disorder currently being treated with disease-modifying therapy or with >10mg/day prednisone
Parallel
Fecal Microbial Transplant Enema
Biological/VaccineRectal infusion of FMT will be administered every 48 hours for 2 doses, on 2 separate occasions, detailed in the study calendar. For each series of FMT administrations, the first dose will be 100g and the second will be 50g. Each FMT will be delivered using a single dose (300 ml of prepared fecal filtrate containing 100g or 50g of stool from a donor) delivered using an enema bag and rectal catheter. The procedure, including preparation steps, will take less than 20 - 30 minutes. The second FMT administration will occur in either the inpatient or outpatient setting depending on whether the patient has been discharged from hospital by the time their second FMT series is due at Day +30. The second FMT series will only occur if patients have a neutrophil count of ANC\>1.0 x 109/L without growth factor support for the last 7 days, documented within 7 days prior to the FMT administration.
Fecal Microbial Transplant Enema
Biological/VaccineRectal infusion of FMT will be administered every 48 hours for 2 doses, on 2 separate occasions, detailed in the study calendar. For each series of FMT administrations, the first dose will be 100g and the second will be 50g. Each FMT will be delivered using a single dose (300 ml of prepared fecal filtrate containing 100g or 50g of stool from a donor) delivered using an enema bag and rectal catheter. The procedure, including preparation steps, will take less than 20 - 30 minutes. The second FMT administration will occur in either the inpatient or outpatient setting depending on whether the patient has been discharged from hospital by the time their second FMT series is due at Day +30. The second FMT series will only occur if patients have a neutrophil count of ANC\>1.0 x 109/L without growth factor support for the last 7 days, documented within 7 days prior to the FMT administration.
To evaluate the feasibility of fecal microbiota transplantation (FMT) in patients undergoing CAR-T or allogeneic stem cell transplantation.
The study hypothesizes successful recruitment of at least 50% of approached patients, retain at least 80% of patients on the study, and successfully administer at least one FMT series to 80% of retained patients.
To evaluate the safety of fecal microbiota transplantation (FMT) in patients undergoing CAR-T or allogeneic stem cell transplantation.
The study hypothesizes that FMT will be safe in this population. Each cohort will be considered separately in considering the differing risks of CAR-T and alloSCT. The study hypothesizes that in each cohort there will be no greater than 10% incidence (N\< 1 of 10 participants in each cohort), of serious adverse events, or Grade \>3 adverse events of special interest (sepsis and/or bacteremia, ICU admission, bowel perforation, or death) within 48 hours of administration of FMT, which are judged to be possibly, probably or definitely related to FMT.
Click on the lead sponsor to view all of their trials.
