title: Palonosetron and dexamethasone for the prevention of nausea and vomiting in patients receiving allogeneic hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors: Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, 2 Yuh Der Road, Taichung 404, Taiwan, supengyeh@gmail.com.
authors: Su-Peng
authors: SP
authors: Yeh
authors: Woei-Chung
authors: WC
authors: Lo
authors: Ching-Yun
authors: CY
authors: Hsieh
authors: Li-Yuan
authors: LY
authors: Bai
authors: Ching-Chan
authors: CC
authors: Lin
authors: Po-Han
authors: PH
authors: Lin
authors: Chen-Yuan
authors: CY
authors: Lin
authors: Yu-Min
authors: YM
authors: Liao
authors: Chang-Fang
authors: CF
authors: Chiu
mesh_terms: D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D002066:Busulfan / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007546:Isoquinolines / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology / Q000517:prevention & control*; D000077924:Palonosetron; D011812:Quinuclidines / Q000627:therapeutic use*; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D014839:Vomiting / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000932:Antiemetics; D007546:Isoquinolines; D011812:Quinuclidines; D000077924:Palonosetron; D003907:Dexamethasone; D003520:Cyclophosphamide; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine