Palonosetron in prevention of nausea and vomiting after highly emetogenic chemotherapy before haematopoietic stem cell transplantation-single center experience.
OBJECTIVE
A clinical study of palonosetron was performed to evaluate its efficacy in preventing both acute and delayed emesis after high-dose chemotherapy (HDC) before hematopoietic stem cell transplantation (HSCT) using a historical control group of patients treated with ondansetron as the comparative drug.


METHODS
Among the 46 evaluated patients 20 with lymphoma received BEAM as the conditioning regimen; 16 has relapsed germ cell tumors treated with CARBOPEC; and 10 with acute myeloid leukemia received BuCY. Increasing severity of nausea was evaluated according to the following 4-grade scale: none (no nausea); mild (slight nausea but no disruption to daily activities); moderate (nausea and some disruption to daily activities); and severe (extreme nausea and severe disruption to daily activities). The emetic response rate was evaluated using the criteria: complete (no emetic episode); major (1-2 episodes); minor (3-5 episodes); and failure (>5 episodes). The response rate of the study drugs was evaluated by the following 4-grade scale based on the condition of nausea and vomiting: highly effective, moderately effective, slightly effective, and not effective.


RESULTS
Patients treated with palonosetron showed significantly greater response rates than those receiving ondansetron during the both the acute and the delayed phases: highly and moderately effective: acute phase 15% versus 5% CARBOPEC; 70% versus 35% BEAM and 32% versus 20% BuCY; delayed phase: 60% versus 30% BuCY; 100% versus 50% BEAM and 25% versus 10% CARBOPEC.


CONCLUSIONS
Single-dose palonosetron was more effective than ondansetron treatment to prevent acute and delayed nausea and vomiting following HDC before HSCT.
Bone Marrow Transplantation Unit, Military Institute of Health Services, 128 Szaserow Street; 00-909 Warsaw, Poland. piotr_rzepecki@poczta.onet.pl
P
P
Rzepecki
W
W
Pielichowski
S
S
Oborska
J
J
Barzal
B
B
Mlot
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002330:Carmustine / Q000627:therapeutic use; D004639:Emetics / Q000009:adverse effects* / Q000627:therapeutic use*; D005047:Etoposide / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007546:Isoquinolines / Q000627:therapeutic use*; D008223:Lymphoma / Q000188:drug therapy / Q000601:surgery; D009325:Nausea / Q000517:prevention & control*; D017294:Ondansetron / Q000627:therapeutic use; D000077924:Palonosetron; D011812:Quinuclidines / Q000627:therapeutic use*; D012702:Serotonin Antagonists / Q000627:therapeutic use*; D016896:Treatment Outcome; D014839:Vomiting / Q000517:prevention & control*
D000970:Antineoplastic Agents; D004639:Emetics; D007546:Isoquinolines; D011812:Quinuclidines; D012702:Serotonin Antagonists; D017294:Ondansetron; D000077924:Palonosetron; D005047:Etoposide; D002330:Carmustine