Feasibility, Safety, and Potential Efficacy of Fecal Microbiota Transplantation (FMT) for Gastrointestinal Dysfunction in Children Following Hematopoietic Cell Transplant (HCT).

Phase 1

Recruiting

• Conditions: Gastro-Intestinal Disorder
• Interventions: Drug: Fecal microbiota transplant (FMT)

• Registration Number: NCT05664113
• Lead Sponsor: St. Jude Children's Research Hospital

Brief Summary

The study participant is being asked to take part in this clinical trial, a type of research study, because the participant has Gastrointestinal (GI) symptoms following a Hematopoietic Cell Transplant (HCT).

Primary Objective

* To determine the safety and feasibility of FMT for treating a GvHD of the gut following HCT.

* To determine the safety and feasibility of FMT for treating HCT induced gut dysfunction.

Secondary Objectives

* To assess the potential efficacy of FMT for treating a GvHD of the gut following HCT.

* To assess the potential efficacy of FMT for treating HCT induced gut dysfunction.

Detailed Description

Participants will be eligible to receive an FMT on or after Day +30 post-HCT. FMT will be performed using FMP material obtained from OpenBiome. 60 mL of FMP will be administered via NJ tube and 250 mL via colonoscopy. A second FMT may be performed at least 14 days after the initial FMT in GI clinical symptoms have partially improved or have not changed. The second FMT will be administered using the same procedure as in the initial FMT

Study Timeline

• Study First Submitted: 2022-12-15
• Study First Submitted QC: 2022-12-15
• Study First Posted: 2022-12-23
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-15
• Last Update Posted: 2025-04-17
• Study Start: 2025-06-12
• Primary Completion: 2025-12-31
• Study Completion: 2028-12-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 10

Inclusion Criteria

• Age < 22 years old.

• Received an allogeneic HCT greater than or equal to 30 days prior to enrollment

• Diagnosed with one of the following conditions:

  1. Steroid-resistant gut a GvHD (defined as GI symptoms that do not improve within 5 days after initial steroid therapy, >/= 1mg/kg of prednisolone) OR

  2. Steroid-dependent gut a GvHD (defined as the presence of a response to methylprednisolone 2 mg/kg/day but relapsing when an attempt was made to taper steroid treatment).

     OR

  3. Current or prolonged GI dysfunction following HCT, defined as having diarrhea or loose stools >/= 4 weeks with at least one of the following:

     1. Requiring NG or G-tube feeds
     2. Requiring TPN or IVF for more than 4 weeks
     3. Diagnosis of gastroparesis by GI specialist documented in the medical record

• Willing and able to provide informed assent/consent

Exclusion Criteria

• Cytomegalovirus (CMV) or Epstein Barr Virus (EBV) IgG negative at the time of consent
• Female participant who is pregnant or nursing
• History of previous FMT
• Intra-abdominal surgery within 4 weeks of enrollment
• At increased risk for peritonitis: presence of intra-abdominal devices (G-or GJ-tubes are acceptable), receiving peritoneal dialysis, or ascites
• Concurrent abdominal radiation therapy
• Any acute or chronic illness/condition as well as medication that in the opinion of the investigator puts the subject at greater risk from FMT or may confound the study results.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Stratum B	Fecal microbiota transplant (FMT)	GI Dysfunction
Stratum A	Fecal microbiota transplant (FMT)	Diagnosed with GvHD

Primary Outcome Measures

Name	Time	Method
Proportion of patients expressing interest who meet eligibility	2 years	Participant eligibility will be a primary outcome measure for the following groups: * FMT for treating a GvHD of the gut following HCT; * FMT for treating HCT induced gut dysfunction
Proportion of participants with a serious adverse event occurring within 30 days following FMT	30 Days	Serious adverse events will be a primary outcome measure for the following groups: * FMT for treating a GvHD of the gut following HCT; * FMT for treating HCT induced gut dysfunction
Proportion of participants providing all protocol required stool samples	3 years	Stool specimens will be a primary outcome measure for the following groups: * FMT for treating a GvHD of the gut following HCT; * FMT for treating HCT induced gut dysfunction
Proportion of participants with a non-serious adverse event occurring within 30 days following FMT	30 Days	Non-serious adverse events will be a primary outcome measure for the following groups: * FMT for treating a GvHD of the gut following HCT; * FMT for treating HCT induced gut dysfunction
Proportion of patients recruited in the eligible population	2 years	Participant recruitment will be a primary outcome measure for the following groups: * FMT for treating a GvHD of the gut following HCT; * FMT for treating HCT induced gut dysfunction
Proportion of participants that drop up post-enrollment	3 years	Participant retention will be a primary outcome measure for the following groups: * FMT for treating a GvHD of the gut following HCT; * FMT for treating HCT induced gut dysfunction

Secondary Outcome Measures

Name	Time	Method
Percentage of participants who reduce or discontinue steroids at the end of the study	1 year	Reduction in dose of steroids will be a secondary outcome measure for the following groups: * FMT for treating a GvHD of the gut following HCT; * FMT for treating HCT induced gut dysfunction
Proportion of participants with a complete response or a partial response	180 days	Complete response or partial response will be a secondary outcome measure for the following groups: * FMT for treating a GvHD of the gut following HCT; * FMT for treating HCT induced gut dysfunction

Trial Locations

Locations (1)

St. Jude Children's Research Hospital; 🇺🇸 Memphis, Tennessee, United States