Gut health of children undergoing treatment for AML

• Research type

  Research Study

• Full title

  Monitor gut health in children undergoing treatment for acute myeloid leukaemia treatment: case-control study

• IRAS ID

  345223

• Contact name

  Graeme O'Connor

• Contact email

  graeme.oconnor@nhs.net

• Sponsor organisation

  Great Ormond Street Hospital

• Duration of Study in the UK

  2 years, 0 months, 0 days

• Research summary

  Acute myeloid leukaemia (AML) is an aggressive cancer with generally poor outcomes compared to childhood lymphoid leukaemia (Arad-Cohen et al., 2022). Intestinal mucositis is one of the most common side effects of chemotherapy (De Pietri et al., 2020). Mucositis results in alterations of absorptive and secretory functions of the intestinal mucosa, haemorrhages, intestinal dysmotility or intestinal failure (McGrath, 2019; Ohta et al., 2003).
  Paediatric cancer patients with chemotherapy-induced mucositis invariably require gut rest and may require intravenous nutrition (Kuiken et al., 2017b). Intravenous nutrition is associated with significant adverse effects, namely dysbiosis of the intestinal microbiome (Tume et al., 2020). Once the mucositis is resolving from gut rest oral/enteral nutrition is gradually re-established.

  Dietary and microbiome-based therapies are being explored for the potential to support recovery of healthy gut microbiome during and after critical illness. In the paediatric population interest is growing in the use of a blended diet for the management of feed intolerances [(Schmitz É et al., 2021)]. However, blended diets are contraindicated in children who are immunocompromised which includes children post chemotherapy.
  Industry have responded to this shift towards blended diets feeding practices and developed a high fiber enteral formula with food derived ingredients, which has been shown to improve enteral feed tolerance [(O'Connor et al., 2022)]. Unlike blended diets these commercially high fibre formulas are safe for children post chemotherapy who are immunocompromised

  This is the first study to observe the impact of AML treatment on the gut microbiome of children on different modes of feeding including intravenous nutrition and food-based formulas. Finally, this study will also observe the recovery phase of the gut microbiome after AML treatment.

• REC name

  West of Scotland REC 4

• REC reference

  24/WS/0130

• Date of REC Opinion

  16 Sep 2024

• REC opinion

  Favourable Opinion