Aprepitant for the control of delayed nausea and vomiting associated with the use of high-dose melphalan for autologous peripheral blood ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-05-17

AUTHORS

Thomas Bechtel, Ali McBride, Brooke Crawford, Susan Bullington, Craig C. Hofmeister, Don M. Benson, Samantha Jaglowski, Sam Penza, Leslie A. Andritsos, Steven M. Devine

ABSTRACT

Study objectiveThe aim of this study is to evaluate the efficacy of aprepitant as part of the antiemetic regimen for high-dose melphalan conditioning in multiple myeloma patients.DesignThis is a prospective, single-arm study.SettingThe study was conducted at an Academic Medical Facility.SubjectsTwenty-six patients receiving high-dose melphalan with autologous stem cell support were included in this study.InterventionEligible patients were >18 years with a diagnosis of MM undergoing high-dose melphalan followed by autologous peripheral blood stem cell transplantation (PBSCT). All patients had serum aminotransferases and total bilirubin less than 2× upper limit of normal. Treatment consisted of aprepitant 125 mg orally on day 1, followed by 80 mg orally 24 and 48 h after the initial dose; ondansetron 16 mg orally day 1; dexamethasone 12 mg orally day 1, and 8 mg orally days 2–4 with breakthrough medications as needed.Measurements and main resultsPatients were evaluated for the frequency of emetic episodes, the need for breakthrough antiemetic medication, and the mean nausea score in 24-h increments beginning 24 h after chemotherapy and continuing until 120 h. Nausea score was determined using a linear analog scale (0–10). Complete response (CR) was defined as no more than one (1) emetic episode during the evaluation period. A total of 26 patients (17 male, 9 female) were enrolled in the study. Of these, 25 (96 %) were complete responders and 24 (92 %) had no documented emetic episodes during the study period. One patient (4 %) had 1 emetic episode and one patient (4 %) had 2 emetic episodes. Some degree of nausea was reported by 23/26 patients, and the mean nausea score for the entire group over the study period was 0.7 (range 0–10).ConclusionsAddition of aprepitant to standard antiemetics resulted in low rates of delayed nausea/vomiting associated with high-dose melphalan and PBSCT, and has now become standard practice in this patient population at our institution. More... »

PAGES

2911-2916

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00520-014-2248-6

DOI

http://dx.doi.org/10.1007/s00520-014-2248-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1010255179

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24838259


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107 rate
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111 scale
112 scores
113 serum aminotransferases
114 single-arm study
115 standard antiemetics
116 standard practice
117 stem cell support
118 stem cell transplant
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120 study
121 study period
122 support
123 total
124 total bilirubin
125 transplant
126 transplantation
127 treatment
128 upper limit
129 use
130 vomiting
131 years
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