Chemotherapy with a side of bacteria, thanks!

The intense chemotherapy used to destroy blood cancer also damages healthy cells in a person’s body, including those that line the intestines and the bacteria that rely on these cells to survive.

Changes in these bacteria (collectively called the gut microbiota) are increasingly linked with detrimental outcomes in people with blood cancer. This can result in a range of acute and chronic side effects, including an increase in the risk of death due to these complications.

A new research project at the University of Adelaide is seeking to improve these outcomes. In collaboration with BiomeBank, Dr Hannah Wardill of the School of Biomedicine is establishing a faecal microbiome transplantation (FMT) service.

FMT is a process where a stool sample is collected from a healthy donor, processed, and then transplanted into the gastrointestinal tract of a patient. It works by “restoring” a damaged microbiome by repopulating the patient’s gut with bacteria that are transplanted from a healthy person.

However, this research project takes a different approach by using the patient’s own faeces and microbiome, in what is called autologous FMT.

“What’s exciting about our approach is that we’re using the patient’s own poo, collected from before they started their treatment,” says Dr Wardill. “In addition to being safer, we think it will be more effective mainly because we all have a unique and intimate relationship with our own gut bacteria, and not those of others.”

Dr Wardill says the project’s goal is to improve the quality of life of people undergoing treatment for blood cancer.

“Our goal is to reduce side effects including diarrhea, infection and graft-versus-host-disease but in the long term, we also hope this approach minimises the risk of relapse, which is thought to be affected by the microbiome, says Dr Wardill. “We also hope to minimise the use of antibiotics, which would help control the rates of antibiotic resistance.”

This project is the first time autologous FMT has been performed in a patient population in Australia.

What’s next?

Dr Wardill hopes the project will lead to the establishment of a state-wide FMT service for people undergoing blood cancer that could be integrated into routine supportive cancer care and in time, expanded to people with other cancers.