The following summary is “Sustained Minimal Residual Disease Negativity in Multiple Myeloma is Associated with Stool Butyrate and Healthier Plant-Based Diets” published in the December 2022 issue of Oncology by Shah et al.
Long-term survival in patients with multiple myeloma is linked to maintaining a minimal residual disease (MRD)-negative status. Modulating host immunity, the gut microbiome is influenced by food choices and can produce short-chain fatty acids like butyrate. Researchers postulated that the microbiome (the number of butyrate-producing bacteria or the amount of butyrate in the feces) is related to the outcome of multiple myeloma treatment. They used a food-frequency questionnaire, gas chromatography-mass spectrometry, and 16S sequencing to analyze the relationship between diets.
The microbiome in myeloma patients on lenalidomide maintenance, specifically the relationship between diet and the -α-diversity and relative abundance of butyrate-producing bacteria. Through the use of a food frequency questionnaire, investigators were able to determine the Healthy Eating Index 2015 score and the flavonoid nutritional levels. When assessing correlations, they employed the Wilcoxon rank sum test, with a 2 significance level of (P<0.05). About 3 months later, MRD negative was still linked to a high stool butyrate concentration (P=0.037), butyrate producers (P=0.025), and α-diversity (P=0.0035).
There was a correlation between butyrate levels and those of 3 months later (P=0.009) and between butyrate levels and sustained MRD negative (P=0.05) among those who consumed more protein from seafood and plants. In addition, stool butyrate concentration was linked with flavonoid intake (anthocyanidins P=0.01, flavones P=0.01, and flavanols P=0.02). Flavonoids are plant nutrients with antioxidant properties. This is the first study to show that a plant-based diet is linked to increased butyrate generation in the gut, which in turn helps maintain MRD negative in patients with multiple myeloma.