Palonosetron in prevention of nausea and vomiting following highly emetogenic chemotherapy before haematopoietic stem cell transplantation- single centre experience
P Rzepecki, S Oborska
Ann Transplant 2009; 14(1): 74-74
Background: A clinical study of palonosetron was carried out to evaluate its
efficacy in preventing both acute and delayed emesis after high-dose chemotherapy [HDC] before hematopoietic stem cell transplantation [HSCT] by using a historical control group of patients treated with ondansetron as the comparative drug.
Material/Methods: 46 patients were evaluated [20- lymphoma and received BEAM as conditioning regimen; 16- relapsed germ cell tumour treated with CARBOPEC; 10- acute myeloid leukaemia received BuCY]. The severity of nausea was evaluated according to the following 4-grade scale: none (no
nausea); mild (slight nausea but no disruption to daily activities); moderate
(nausea and some disruption to daily activities);and severe (extreme nausea and severe disruption to daily activities).The emetic response rate was evaluated using the following criteria: complete (no emetic episode); major (1 to 2 episodes); minor (3 to 5 episodes); and failure (>5 episodes). The response rate of the study drugs was evaluated by the following 4-grade scale based on the condition of nausea and vomiting: highly effective, moderately effective, slightly effective and not effective.
Results: Patients treated with palonosetron had significantly higher response
rates than those receiving ondansetron during the both: acute and delayed
phases [highly moderately effective: acute phase 15% vs. 5% CARBOPEC; 70% vs. 35% BEAM and 32% vs. 20% BuCY; delayed phase: 60% vs. 30% BuCY; 100% vs. 50% BEAM and 25% vs. 10% CARBOPEC.
Conclusions: Single-dose palonosetron was more effective than ondansetron treatment in preventing acute and delayed nausea and vomiting following HDC before HSCT.
Keywords: Bone Marrow Transplantation, Stem Cell Transplantation