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Medline ® Abstract for Reference 131

of 'Prevention and treatment of chemotherapy-induced nausea and vomiting in adults'

Palonosetron and dexamethasone for the prevention of nausea and vomiting in patients receiving allogeneic hematopoietic stem cell transplantation.
Yeh SP, Lo WC, Hsieh CY, Bai LY, Lin CC, Lin PH, Lin CY, Liao YM, Chiu CF
Support Care Cancer. 2014 May;22(5):1199-206. Epub 2013 Dec 7.
PURPOSE: The primary aim of this study was to evaluate the efficacy of palonosetron combined with dexamethasone in the prevention of vomiting, and especially nausea, in patients receiving allogeneic stem cell transplantation.
METHODS: Palonosetron 0.25 mg was given to 27 patients receiving allogeneic transplantation on the first day of conditioning, and then every other day during the entire conditioning period. Dexamethasone was given daily also during conditioning. Vomiting and nausea were recorded daily according to CTCAE version 4.0 from the start of conditioning to Day 7 after transplantation. In addition, MASCC antiemetic tool (MAT) was also used in parallel to evaluate the intensity of nausea.
RESULTS: The treatment was well tolerated; 25.9 and 40.7 % of the patients had grade 2/3 vomiting and nausea respectively during conditioning. The incidences of grade 2/3 vomiting and nausea were even higher in the first week after transplantation (40.7 and 51.8 %, respectively). The score of MAT correlated well with the grade of CTCAE. However, the difference in the mean intensity of nausea between period of conditioning and the first week after HSCT was significant only by using MAT (0.96 ± 1.829 vs. 3.81 ± 3.386, p = 0.001) but not CTCAE (1.26 ± 0.903 vs. 1.63 ± 0.967, p = 0.152).
CONCLUSION: Palonosetron combined with dexamethasone is effective in preventing vomiting during conditioning. However, more effort should be made to alleviate nausea during conditioning and both nausea and vomiting in the first week after transplantation. Furthermore, MAT has a higher discriminant power than CTCAE in assessing the intensity of nausea in patients receiving allogeneic transplantation.
Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, 2 Yuh Der Road, Taichung 404, Taiwan, supengyeh@gmail.com.