title: Efficacy of aprepitant in preventing nausea and vomiting due to high-dose melphalan-based conditioning for allogeneic hematopoietic stem cell transplantation.
abstract: High-dose melphalan has been gaining recognition as a highly emetogenic agent used in hematopoietic stem cell transplantation (HSCT). The aim of this retrospective study was to elucidate the efficacy of aprepitant in preventing high-dose melphalan-induced emesis. Sixty patients who received melphalan (70 mg/m(2)/day, 2 days) and fludarabine (125 mg/m(2)/day, 5 days) as conditioning for allogeneic HSCT for hematological malignancies, and who received ondansetron and methylprednisolone as an antiemetic prophylaxis, were eligible. Twenty of these 60 patients also received aprepitant for 5 days (aprepitant group); the remaining 40 patients served as a control. The rates of complete response (CR), defined as no emesis without rescue medications, and complete protection (CP), defined as no emesis with or without rescue medications, were assessed between the two groups. The observation period was 12 days from the first day of melphalan administration. The CR and CP rates were significantly higher in the aprepitant group than in the control group during the observation period (35 % versus 10 %, P < 0.05; 85 % versus 33 %, P < 0.001; respectively). These results suggest that aprepitant in combination with ondansetron and steroid effectively ameliorates nausea and vomiting caused by the high-dose melphalan-based conditioning for allogeneic HSCT.
authors.affiliation: Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Sakurai
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.forename: Jun
authors.initials: J
authors.lastname: Kato
authors.forename: Yuya
authors.initials: Y
authors.lastname: Koda
authors.forename: Taku
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Sumiko
authors.initials: S
authors.lastname: Kohashi
authors.forename: Masuho
authors.initials: M
authors.lastname: Saburi
authors.forename: Takaaki
authors.initials: T
authors.lastname: Toyama
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Aisa
authors.forename: Tomonori
authors.initials: T
authors.lastname: Nakazato
authors.forename: Noriko
authors.initials: N
authors.lastname: Beppu
authors.forename: Soichiro
authors.initials: S
authors.lastname: Tsuda
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Shigematsu
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okamoto
mesh_terms: D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000077608:Aprepitant; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*; D019653:Myeloablative Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy*; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014184:Transplantation, Homologous; D014839:Vomiting / Q000139:chemically induced / Q000188:drug therapy*
chemical_list: D000932:Antiemetics; D009025:Morpholines; D019653:Myeloablative Agonists; D000077608:Aprepitant; D008558:Melphalan