{"doi":"10.1101/2022.03.29.22272361","title":"Sustained Minimal Residual Disease Negativity in Multiple Myeloma is Associated with Stool Butyrate and Healthier Plant-Based Diets","abstract":"Abstract Sustained minimal residual disease (MRD) negativity is associated with long-term survival in multiple myeloma (MM). The gut microbiome is affected by diet, and in turn can modulate host immunity, for example through production of short-chain fatty acids including butyrate. We examined the relationship of dietary factors, stool metabolites, and microbial diversity with sustained MRD negativity in patients on lenalidomide maintenance. At 3 months, higher stool butyrate concentration (p=0.037), butyrate producers (p=0.025) and α-diversity (p=0.0035) were associated with sustained MRD-negativity. Healthier dietary proteins, (from seafood and plants), correlated with butyrate at 3 months (p=0.009) and sustained MRD-negativity (p=0.05). Consumption of dietary flavonoids, plant nutrients with antioxidant effects, correlated with stool butyrate concentration (anthocyanidins p=0.01, flavones p=0.01, and flavanols p=0.02). This is the first study to demonstrate an association between a plant-based dietary pattern, stool butyrate production and sustained MRD-negativity in MM; providing rationale to evaluate a prospective dietary intervention. Statement of Significance We demonstrate an association between diet, the gut microbiome, and sustained MRD-negativity in MM. A healthy diet, with adequate plant and seafood protein, and containing flavonoids, associates with stool diversity, butyrate production and sustained MRD-negativity. These findings suggest dietary modification should be studied to enhance myeloma control. Key Points In MM on lenalidomide maintenance, stool butyrate concentration at 3 months was associated with higher rates of MRD negativity at 12 months. Increased seafood and plant proteins, dietary flavonoids, and diversity of dietary flavonoids correlated with stool butyrate concentrations.","journal":"medRxiv","year":2022,"id":300059,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9592,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":298163,"name":"Kylee Maclachlan","orcid":"0000-0001-7873-4854","position":1,"is_corresponding":false},{"id":348015,"name":"Andriy Derkach","orcid":"0000-0003-2178-8493","position":2,"is_corresponding":false},{"id":990265,"name":"Meghan Salcedo","orcid":"0000-0003-4010-1829","position":3,"is_corresponding":false},{"id":990266,"name":"Kelly Barnett","orcid":"0000-0001-8389-0341","position":4,"is_corresponding":false},{"id":990267,"name":"Julia Caple","orcid":"0000-0002-6310-6334","position":5,"is_corresponding":false},{"id":990268,"name":"Jenna Blaslov","orcid":"0000-0002-2871-457X","position":6,"is_corresponding":false},{"id":990269,"name":"Linh Tran","orcid":"0000-0001-8827-6471","position":7,"is_corresponding":false},{"id":990270,"name":"Amanda Ciardiello","orcid":"0000-0001-9463-8168","position":8,"is_corresponding":false},{"id":990271,"name":"Miranda Burge","orcid":"0000-0002-5236-4514","position":9,"is_corresponding":false},{"id":990272,"name":"Tala Shekarkhand","orcid":"0000-0002-1404-4771","position":10,"is_corresponding":false},{"id":906035,"name":"Peter Adintori","orcid":"0000-0001-7099-1143","position":11,"is_corresponding":false},{"id":218459,"name":"Justin R. 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