title: Delayed chemotherapy-induced nausea and vomiting in autologous hematopoietic cell transplant patients: an exploratory analysis.
abstract: OBJECTIVE
  Delayed chemotherapy-induced nausea and vomiting (CINV) continues to be a problem in patients undergoing a hematopoietic cell transplant (HCT) despite progress in antiemetic prophylaxis. This study investigated the clinical course of nausea and vomiting (NV) and retching over the 5 days following an autologous HCT in a transplant setting.
  
  
  METHODS
  This longitudinal observational study was an exploratory analysis of data from a trial that assessed the efficacy of aroma in preventing NV related to dimethyl sulfoxide in 69 autologous HCT patients undergoing highly emetogenic chemotherapy (HEC; n = 56) or moderately emetogenic chemotherapy (MEC; n = 13).
  
  
  RESULTS
  Nausea started to increase on the second day after reinfusion, with a peak between 72 and 96 hours, and decreased on the fifth day. The pattern for vomiting was similar, while retching episodes remained unchanged after the third day following transplant. Nausea and emesis were observed in 73% (n = 41) and 64% (n = 36) of HEC patients, respectively, and in 85% (n = 11) and 62% (n = 8) of MEC patients, respectively.
  
  
  CONCLUSIONS
  Uncontrolled delayed CINV is still a challenge for autologous HCT patients. Nausea, vomiting and retching are 3 different symptoms that should be assessed and managed separately in routine clinical practice.
authors.affiliation: Department of Public Health and Paediatric Sciences, University of Torino, Torino - Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Gonella
authors.affiliation: Department of Public Health and Paediatric Sciences, University of Torino, Torino - Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Di Giulio
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000932:Antiemetics / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D018380:Hematopoietic Stem Cell Transplantation; D007558:Italy; D008137:Longitudinal Studies; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy; D011322:Primary Prevention; D011446:Prospective Studies; D011788:Quality of Life; D055502:Secondary Prevention; D013997:Time Factors; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014182:Transplantation, Autologous; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents