Prevention of Chemotherapy-induced Nausea and Vomiting After High-dose Melphalan and Stem Cell Transplantation: Review of the Evidence and Suggestions

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2018 Dec 20

PMID 30564934

Citations 3

Authors

Andrea Tendas

Francesco Marchesi

Andrea Mengarelli

Ombretta Annibali

Valeria Tomarchio

Debora Saltarelli

Anna Chierichini

Mirko Di Venanzio

Fabio Sollazzo

Monica Piedimonte

Luca Cupelli

Antoine Bruno

Gottardo De Angelis

Luciano Delbono

Pasquale Niscola

Alessio Pio Perrotti

Paolo de Fabritiis

William Arcese

Affiliations

Soon will be listed here.

Abstract

Introduction: High-dose melphalan (HDMel) is the most common conditioning chemotherapy regimen for autologous stem cell transplantation (SCT) in patients affected by multiple myeloma (MM). No consensus exists for the emetogenicity or prophylaxis of chemotherapy-induced nausea and vomiting (CINV) in this regimen.

Methods: Data on the incidence and efficacy/safety of CINV prophylaxis among patients affected by MM undergoing autologous SCT with the HDMel regimen was extracted from electronic databases and analyzed.

Results: Eleven studies involving multiple CINV prophylaxis regimens were identified and included. No consensus on HDMel emetogenicity was reached, but most studies summarized the emetogenicity as moderate-high risk. An aprepitant-based three-drug regimen (aprepitant + serotonin receptor antagonist (5HT3RA) + dexamethasone) showed better efficacy than a two-drug regimen (5HT3RA + dexamethasone) for CINV prevention without increasing the frequency in adverse events.

Conclusions: The aprepitant-based three-drug regimen should be the regimen of choice for CINV prophylaxis for MM patients undergoing autologous SCT with HDMel conditioning.

Citing Articles

Practical management of disease-related manifestations and drug toxicities in patients with multiple myeloma.

Geraldes C, Roque A, Sarmento-Ribeiro A, Neves M, Ionita A, Gerivaz R Front Oncol. 2024; 14:1282300.

PMID: 38585008 PMC: 10995327. DOI: 10.3389/fonc.2024.1282300.

Antiemetic Strategies in Patients Who Undergo Hematopoietic Stem Cell Transplantation.

Yuda S, Fuji S, Savani B, Gatwood K Clin Hematol Int. 2022; 4(3):89-98.

PMID: 36131129 PMC: 9492824. DOI: 10.1007/s44228-022-00012-8.

Efficacy and safety of netupitant/palonosetron combination (NEPA) in preventing nausea and vomiting in non-Hodgkin's lymphoma patients undergoing to chemomobilization before autologous stem cell transplantation.

Di Renzo N, Musso M, Scime R, Cupri A, Perrone T, De Risi C Support Care Cancer. 2021; 30(2):1521-1527.

PMID: 34533630 PMC: 8727426. DOI: 10.1007/s00520-021-06495-0.

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