title: Fosaprepitant for the prevention of nausea and vomiting in patients receiving BEAM or high-dose melphalan before autologous hematopoietic stem cell transplant.
abstract: OBJECTIVE
  To assess the impact of single-dose fosaprepitant on nausea and emesis after BEAM and high-dose melphalan conditioning regimens for autologous hematopoietic stem cell transplantation.
  
  
  METHODS
  In a single-center cohort study patients receiving melphalan containing hematopoietic stem cell transplantation regimens who received a one-time dose of 150 mg IV fosaprepitant (n = 56) were compared to a historical control (n = 70).
  
  
  RESULTS
  The primary endpoint of no emesis from melphalan administration through five days afterward was 80% for the fosaprepitant group versus 66% in the control group (p = 0.068). Addition of fosaprepitant demonstrated significant improvement in emetic episodes per patient during the entire assessment period (p = 0.011) and days 1-5 after melphalan (p = 0.045). Fosaprepitant resulted in no substantial nausea during the entire assessment period in 37% of high-dose melphalan patients and 57% of BEAM patients.
  
  
  CONCLUSIONS
  Further studies are suggested to investigate the optimal number and timing of doses of fosaprepitant in this setting.
authors.affiliation: Department of Pharmacy, Georgia Regents Medical Center, Augusta, GA, USA Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA Georgia Regents University Cancer Center, Augusta, GA, USA stclark@gru.edu.
authors.forename: Stephen Michael
authors.initials: SM
authors.lastname: Clark
authors.affiliation: Department of Pharmacy, Georgia Regents Medical Center, Augusta, GA, USA Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA Georgia Regents University Cancer Center, Augusta, GA, USA.
authors.forename: Amber B
authors.initials: AB
authors.lastname: Clemmons
authors.affiliation: Department of Pharmacy, Grady Health System, Atlanta, GA, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Schaack
authors.affiliation: Department of Biostatistics and Epidemiology, Georgia Regents University, Augusta, GA, USA.
authors.forename: Jeonifer
authors.initials: J
authors.lastname: Garren
authors.affiliation: Department of Pharmacy, Georgia Regents Medical Center, Augusta, GA, USA Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Augusta, GA, USA Georgia Regents University Cancer Center, Augusta, GA, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: DeRemer
authors.affiliation: Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Vamsi K
authors.initials: VK
authors.lastname: Kota
mesh_terms: D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects; D015331:Cohort Studies; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D011034:Podophyllotoxin / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D018906:Antineoplastic Agents, Alkylating; D009025:Morpholines; D003561:Cytarabine; C579707:fosaprepitant; D011034:Podophyllotoxin; D008558:Melphalan; D002330:Carmustine
keywords: fosaprepitant; hematopoietic stem cell transplant; nausea; vomiting