title: Palonosetron, aprepitant, and dexamethasone for prevention of nausea and vomiting after high-dose melphalan in autologous transplantation for multiple myeloma: A phase II study.
abstract: Chemotherapy-induced nausea and vomiting (CINV) is a significant side effect in multiple myeloma (MM) patients receiving high-dose melphalan treatment followed by autologous stem cell transplantation (ASCT). We evaluated the efficacy and safety of a triple antiemetic combination of palonosetron, aprepitant, and low-dose dexamethasone in 24 MM patients who received melphalan conditioning (100 mg/m2on days 1-2) before ASCT (on day 4). Intravenous palonosetron (0.75 mg on day 1), oral aprepitant (125 mg on day 1; 80 mg on days 2-4), and intravenous dexamethasone (6.6 mg on days 1-4) were administered for prevention of CINV. Complete response (no emesis and no rescue antiemetic) and complete control (no emesis, no rescue antiemetic, and no more than mild nausea) rates were 75 and 68% during the overall phase (0-120 h), while they were 88 and 86% in the acute phase (0-48 h), 75 and 68% in the delayed phase (48-120 h), and 67 and 59% in the extended phase (120-168 h), respectively. There were no serious adverse events related to the antiemetic therapy. In conclusion, the three-antiemetic regimen consisting of palonosetron, aprepitant, and dexamethasone was safe and effective for controlling CINV due to high-dose melphalan treatment, especially during the delayed phase.
authors.affiliation: Department of Hematology, National Hospital Organization Shibukawa Medical Center, 383 Shiroi, Shibukawa, Gunma, 377-0280, Japan. aisoda@sbmc.hosp.go.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Isoda
authors.affiliation: Department of Pharmacy, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Saito
authors.affiliation: Department of Pharmacy, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, Japan.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Komatsu
authors.affiliation: Department of Pharmacy, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Negishi
authors.affiliation: Department of Pharmacy, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, Japan.
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Oosawa
authors.affiliation: Department of Hematology, National Hospital Organization Shibukawa Medical Center, 383 Shiroi, Shibukawa, Gunma, 377-0280, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ishikawa
authors.affiliation: Department of Hematology, National Hospital Organization Shibukawa Medical Center, 383 Shiroi, Shibukawa, Gunma, 377-0280, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Miyazawa
authors.affiliation: Department of Hematology, National Hospital Organization Shibukawa Medical Center, 383 Shiroi, Shibukawa, Gunma, 377-0280, Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Clinical Research, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Sawamura
authors.affiliation: Department of Pharmacy, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, Japan.|Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Manaka
mesh_terms: D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D000077608:Aprepitant; D003907:Dexamethasone / Q000008:administration & dosage; D004359:Drug Therapy, Combination / Q000379:methods*; D006801:Humans; D007546:Isoquinolines / Q000008:administration & dosage; D008558:Melphalan / Q000008:administration & dosage*; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage; D009101:Multiple Myeloma / Q000628:therapy*; D019653:Myeloablative Agonists / Q000627:therapeutic use; D000077924:Palonosetron; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000517:prevention & control*; D011812:Quinuclidines / Q000008:administration & dosage; D014182:Transplantation, Autologous / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000932:Antiemetics; D007546:Isoquinolines; D009025:Morpholines; D019653:Myeloablative Agonists; D011812:Quinuclidines; D000077608:Aprepitant; D000077924:Palonosetron; D003907:Dexamethasone; D008558:Melphalan
keywords: Aprepitant; High-dose melphalan; Multiple myeloma; Nausea; Palonosetron