Abstract 804: Gut microbiota, health-promoting lifestyle behaviors, and symptoms of pain and fatigue in hematopoietic cell transplantation survivors

Abstract Hematopoietic cell transplantation (HCT) is a critical treatment for hematological malignancies, but survivors often face long-term health challenges, including complications related to immune dysfunction, gut microbiota (GM) alterations, and physical symptoms. Recent research has highlighted the important role of health-promoting lifestyle behaviors (HPLBs), such as diet, physical activity, and stress management, in improving health outcomes among HCT survivors. This study is a post-transplant analysis (30 days) of 55 adults (> 18 years of age) from a longitudinal descriptive study of GM composition diversity using Chao, Shannon, and health-promoting lifestyle profile domains measured by the HPLPII that includes health responsibilities, physical activities, nutrition, spiritual growth, interpersonal relationships, and stress management. Pain and fatigue were measured using the Memorial Symptom Assessment Scale, GM was assessed using 16S ribosomal gene (V4 region) amplicons from Illumina MiSeq. Data analysis was performed with the Python ‘pandas’ package using robust Pearson correlations for finding linear correlations and production of 95% Credibility Intervals (CI) align with Canonical Correlation using scikit-learn library and Kernel Correlation using rbf_kernel function to find nonlinear associations with (p<0.05) significance level. The study sample was comprised of 77% white,19.3% African American or Black, and included 2.5% Hispanic ethnicity. The mean age of participants was 56.21 years + 14.67 years, participants were diagnosed with Lymphoma (46.2%), Leukemia (27.7%), Multiple Myeloma (16.80%) and Myelodysplastic syndrome (9.24%) and the majority received autologous HCT (39.16%). Both Canonical and Kernel correlations between health-promoting lifestyle scores, gut microbiota number of OTUs, and pain-related metrics showed moderate association with 0.60 and 0.4. Pearson correlation revealed a negative association between stress management domain and pain (r= -0.30) pain severity (r= -0.26), fatigue (r= -0.37), fatigue interference (r= -0.44) and negative association between physical activity and pain frequency (r= -0.4) and severity (r= -0.4) and fatigue (r= -0.21). The physical activity domain showed a positive correlation with the Chao index (r= 0.11) and the Shannon index (r= 0.14). The nutrition domain showed a positive association between Chao (r= 0.11) and Shannon (r= 0.07). Also, positive associations between pain frequency (r= 0.10), pain severity (r= 0.19), pain distress (r= 0.20) and the spiritual growth domain were identified. These findings highlight the potential of multi-domain lifestyle interventions in enhancing post-HCT recovery and improving gut microbiota diversity. Further research is warranted to confirm these associations and refine health promotion strategies for HCT survivors. Citation Format: Elham Samami, Angela Starkweather, Debra Lyon, Debra Kelly. Gut microbiota, health-promoting lifestyle behaviors, and symptoms of pain and fatigue in hematopoietic cell transplantation survivors. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 804.