TY - JOUR
T1 - Combined use of multiday palonosetron with aprepitant and low-dose dexamethasone in prevention of nausea and emesis among patients with multiple myeloma and lymphoma undergoing autologous hematopoietic stem cell transplant
T2 - A pilot study
AU - Deauna-Limayo, Delva
AU - Aljitawi, Omar S.
AU - Ganguly, Siddhartha
AU - Abhyankar, Sunil
AU - Wick, Jo A.
AU - McGuirk, Joseph P.
N1 - Funding Information:
We thank Anna Ludlow for her help with preparation of the figures. Dr Wick was supported by a CTSA grant from NCRR and NCATS awarded to the University of Kansas Medical Center for Frontiers: The Heartland Institute for Clinical and Translational Research # KL2TR000119. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH, NCRR, or NCATS. O.S.A. is a recipient of a research career award by the Office of Scholarly, Academic & Research Mentoring (OSARM) at home institution.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/8
Y1 - 2014/8
N2 - Background: The current standard for prevention of chemotherapy-induced nausea/vomiting in autologous stem cell transplant only achieves 4-20% emetic control. Objectives: To assess emetic responses to multiday palonosetron, aprepitant, and low-dose dexamethasone among patients with myeloma and lymphoma undergoing autologous hematopoietic stem cell transplant. Methods: Oral aprepitant 125/80/80 mg was administered with intravenous dexamethasone 4 mg and palonosetron 0.25 mg on days -3, -2, -1 for multiple myeloma and days -7 through -3 for lymphoma. Palonosetron was repeated day +3 in both groups. Results: A total of 20 patients were enrolled and 18 analyzed. None experienced emetic failure with complete control achieved in 78, 33, and 17% in the acute, delayed, and extended phases, respectively. Nausea occurred in 78% although not significant in 61%, with median Nausea Visual Score of 4.5. Quality of life correlated with emetic and nausea control. Eight patients developed grade 2-3 nonhematologic toxicities with only one event attributed to the study medications. Conclusions: This triplet regimen was feasible with acceptable safety profile in the autologous hematopoietic stem cell transplant setting. Emetic control was best achieved in the acute phase. Lesser degree of emetic and nausea control in the delayed and extended phases impacted quality of life. Our results warrant further evaluation in a larger autologous hematopoietic stem cell transplant population.
AB - Background: The current standard for prevention of chemotherapy-induced nausea/vomiting in autologous stem cell transplant only achieves 4-20% emetic control. Objectives: To assess emetic responses to multiday palonosetron, aprepitant, and low-dose dexamethasone among patients with myeloma and lymphoma undergoing autologous hematopoietic stem cell transplant. Methods: Oral aprepitant 125/80/80 mg was administered with intravenous dexamethasone 4 mg and palonosetron 0.25 mg on days -3, -2, -1 for multiple myeloma and days -7 through -3 for lymphoma. Palonosetron was repeated day +3 in both groups. Results: A total of 20 patients were enrolled and 18 analyzed. None experienced emetic failure with complete control achieved in 78, 33, and 17% in the acute, delayed, and extended phases, respectively. Nausea occurred in 78% although not significant in 61%, with median Nausea Visual Score of 4.5. Quality of life correlated with emetic and nausea control. Eight patients developed grade 2-3 nonhematologic toxicities with only one event attributed to the study medications. Conclusions: This triplet regimen was feasible with acceptable safety profile in the autologous hematopoietic stem cell transplant setting. Emetic control was best achieved in the acute phase. Lesser degree of emetic and nausea control in the delayed and extended phases impacted quality of life. Our results warrant further evaluation in a larger autologous hematopoietic stem cell transplant population.
KW - Aprepitant
KW - Autologous hematopoietic stem cell transplant
KW - Chemotherapy-induced nausea and vomiting
KW - Multiday palonosetron
UR - http://www.scopus.com/inward/record.url?scp=84905655973&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84905655973&partnerID=8YFLogxK
U2 - 10.1177/1078155213502103
DO - 10.1177/1078155213502103
M3 - Article
C2 - 24005093
AN - SCOPUS:84905655973
VL - 20
SP - 263
EP - 269
JO - Journal of Oncology Pharmacy Practice
JF - Journal of Oncology Pharmacy Practice
SN - 1078-1552
IS - 4
ER -