Prospective evaluation of antiemetic outcome following high-dose chemotherapy with hematopoietic stem cell support
Department of Medicine; Cancer Center
Adult; Aged; Antiemetics; Antineoplastic Agents; Female; *Hematopoietic Stem Cell Transplantation; Humans; Logistic Models; Male; Middle Aged; Nausea; Prospective Studies; Transplantation Conditioning; Treatment Outcome; Vomiting
Considerable progress has been made in improving the control of chemotherapy-induced emesis. The impact of available antiemetic options for patients receiving stem cell transplants is unclear, as few prospective data have been collected. We prospectively evaluated antiemetic outcome in patients receiving stem cell transplantation over a 7-day period following the initiation of chemotherapy. The primary endpoints were the number of emetic episodes and the extent of nausea measured on a four-point scale. Eighty-two patients were evaluated. Ninety-five percent of patients had nausea during the first week of treatment; 80% had at least one emetic episode. The percentage of patients with emesis was as follows: day 1: 13%, day 2: 21%, day 3: 30%, day 4: 38%, day 5: 44%, day 6: 39%, day 7: 18%. In multivariate analysis, gender, emesis with prior chemotherapy, history of morning or motion sickness, type of transplant (auto vs allo), use of total body irradiation, or use of dexamethasone did not effect emesis control. Most patients receiving high-dose chemotherapy experience incompletely controlled emesis. Control of nausea and emesis progressively worsened with each subsequent day following initiation of chemotherapy, reaching a nadir on day 5. New treatment approaches are needed to improve emesis control in this patient population.
DOI of Published Version
Bone Marrow Transplant. 2001 Dec;28(11):1061-6. Link to article on publisher's site
Bone marrow transplantation
Ballen, Karen K.; Heseth, Ann M.; Heyes, Christine; Becker, Pamela S.; Emmons, Robert V. B.; Fogarty, Kevin E.; LaPointe, Janet; Liu, Qin; Hsieh, Chung-Cheng; and Hesketh, Paul J., "Prospective evaluation of antiemetic outcome following high-dose chemotherapy with hematopoietic stem cell support" (2002). Open Access Articles. 321.