Mycobiome Supporting Diet to Reduce GI Toxicity Associated With ASCT

Study Overview
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Brief Summary
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The purpose of this study is to determine if this specific Mycobiome Supporting Diet (MSD diet) can help reduce gut inflammation during post-transplant period. The MSD is an special diet which will be explained in detail by a dietician that works by supporting the body's good gut bacteria and fungi.

Detailed Description
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This is a non-randomized cohort study. Participants will be on a specific diet for 4 weeks prior to transplant and 10 days after transplant, and will then be asked to fill out several questionnaires during this period to see if this diet is easy and simple to follow. The questionnaires will be weekly while participants are outpatient and once admitted to the hospital, participants will need to fill it on the last day (10 days after stem cell infusion). Participants will also be requested to provide fecal swab samples which we will test for bacteria and fungi. A total of 3 samples will be taken at different time points during this study.

Official Title
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Mycobiome Supporting Diet (MSD) to Reduce Gastrointestinal (GI) Toxicity Associated With Autologous Stem Cell Transplant (ASCT) For Patients With Multiple Myeloma (MM)

Conditions
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Myeloma, Autologous Transplant

Intervention / Treatment
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* Behavioral: Mycobiome Supporting Diet


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Eligible for first autologous transplant for myeloma Willing to adhere to the allowed and disallowed foods of the diet plan. Able to get and prepare their own food items for all meals during the study Exclusion Criteria: Active inflammatory bowel disease, celiac disease, other chronic intestinal disorders Pregnant women, planning to get pregnant or breastfeeding Prior bowel resection Inability to tolerate the study diet due to allergies/ intolerance/ preference Inability to consent to trial Patients with restrictions in diet including inability to have oral nutrition with regular consistency Any condition that the investigator feels may limit the volunteer's ability to complete the study protocol. Patients with absolute neutrophil count (ANC) < 1000 on long term antibacterial prophylaxis ongoing 3 days prior to enrollment Patients who received antifungal therapy in 3 days prior to enrollment Patients who received steroid therapy in 7 days prior to enrollment

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mycobiome Supporting Diet<br>Participants will be able to abide by the allowed and disallowed foods in MSD diet for at least four consecutive weeks prior to conditioning and up to 10 days after transplant. Participants will maintain a diary of foods they consume and any adverse effects they are experiencing and will self- collect fecal samples 28 days before transplant, 2 days before transplant and 10 days after transplant | Behavioral: Mycobiome Supporting Diet<br>* MSD takes combines elements from several diets (e.g., Paleo, low-carbohydrate, vegetarian, and Mediterranean) and excludes elements of these diets that have been specifically proven to increase pathogenic fungi in the human gut.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percent of participants with at least 2 out of 3 assessments marked more than half the time on compliance questionnaire | MSD adherence feasibility measured by percent of participants with at least 2 out of 3 assessments marked more than half the time on compliance questionnaire. The questionnaire includes a multiple choice questions about adherence to diet (4 levels, from 'not at all' to 'the whole time'), a multiple choice question identifying barriers to adherence, and 8 yes/no questions about medication use and symptom experience. The MSD diet will deem feasible if at least 80 percent of participants showed adherence defined by 2 out of 3 assessment marked more than half the time. | 21 days prior to Transplant (an average of 1 month from start of study) | 
| Percent of participants with at least 2 out of 3 assessments marked more than half the time on compliance questionnaire | MSD adherence feasibility measured by percent of participants with at least 2 out of 3 assessments marked more than half the time on compliance questionnaire. The questionnaire includes a multiple choice questions about adherence to diet (4 levels, from 'not at all' to 'the whole time'), a multiple choice question identifying barriers to adherence, and 8 yes/no questions about medication use and symptom experience. The MSD diet will deem feasible if at least 80 percent of participants showed adherence defined by 2 out of 3 assessment marked more than half the time. | 14 days prior to transplant (an average of 1 month from start of study) | 
| Percent of participants with at least 2 out of 3 assessments marked more than half the time on compliance questionnaire | MSD adherence feasibility measured by percent of participants with at least 2 out of 3 assessments marked more than half the time on compliance questionnaire. The questionnaire includes a multiple choice questions about adherence to diet (4 levels, from 'not at all' to 'the whole time'), a multiple choice question identifying barriers to adherence, and 8 yes/no questions about medication use and symptom experience. The MSD diet will deem feasible if at least 80 percent of participants showed adherence defined by 2 out of 3 assessment marked more than half the time. | 7 days prior to transplant (an average of 1 month from start of study) | 
| Patient-reported outcome (PRO)-Common Terminology Criteria for Adverse Even CTCAE questionnaire | Patient perception of symptoms measured using PRO-CTCAE questionnaire, consisting of 15 questions with frequency and severity scores, questions ranging 1 to 5, 5 is worse and 1 is less | After baseline (7 days post-transplant) | 
| PRO-CTCAE questionnaire scores | Patient perception of symptoms measured using PRO-CTCAE questionnaire, consisting of 15 questions with frequency and severity scores, questions ranging 1 to 5, 5 is worse and 1 is less | week 1 in the 1 month prior to transplant | 
| PRO-CTCAE questionnaire scores | Patient perception of symptoms measured using PRO-CTCAE questionnaire, consisting of 15 questions with frequency and severity scores, questions ranging 1 to 5, 5 is worse and 1 is less | week 2 in the 1 month prior to transplant | 
| PRO-CTCAE questionnaire scores | Patient perception of symptoms measured using PRO-CTCAE questionnaire, consisting of 15 questions with frequency and severity scores, questions ranging 1 to 5, 5 is worse and 1 is less | week 3 in the 1 month prior to transplant | 
| PRO-CTCAE questionnaire scores | Patient perception of symptoms measured using PRO-CTCAE questionnaire, consisting of 15 questions with frequency and severity scores, questions ranging 1 to 5, 5 is worse and 1 is less | week 4 in the 1 month prior to transplant |