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01-03-2019 | Review Article

Prevention of chemotherapy-induced nausea and vomiting after high-dose melphalan and stem cell transplantation: review of the evidence and suggestions

Authors: Andrea Tendas, Francesco Marchesi, Andrea Mengarelli, Ombretta Annibali, Valeria Tomarchio, Debora Saltarelli, Anna Chierichini, Mirko Di Venanzio, Fabio Sollazzo, Monica Piedimonte, Luca Cupelli, Antoine Bruno, Gottardo De Angelis, Luciano Delbono, Pasquale Niscola, Alessio Pio Perrotti, Paolo de Fabritiis, William Arcese, On behalf of Rome Transplant Network

Published in: Supportive Care in Cancer | Issue 3/2019

Abstract

Introduction

High-dose melphalan (HDMel) is the most common conditioning chemotherapy regimen for autologous stem cell transplantation (SCT) in patients affected by multiple myeloma (MM). No consensus exists for the emetogenicity or prophylaxis of chemotherapy-induced nausea and vomiting (CINV) in this regimen.

Methods

Data on the incidence and efficacy/safety of CINV prophylaxis among patients affected by MM undergoing autologous SCT with the HDMel regimen was extracted from electronic databases and analyzed.

Results

Eleven studies involving multiple CINV prophylaxis regimens were identified and included. No consensus on HDMel emetogenicity was reached, but most studies summarized the emetogenicity as moderate-high risk. An aprepitant-based three-drug regimen (aprepitant + serotonin receptor antagonist (5HT3RA) + dexamethasone) showed better efficacy than a two-drug regimen (5HT3RA + dexamethasone) for CINV prevention without increasing the frequency in adverse events.

Conclusions

The aprepitant-based three-drug regimen should be the regimen of choice for CINV prophylaxis for MM patients undergoing autologous SCT with HDMel conditioning.

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Tendas A, Marchesi F, Annibali O, Saltarelli D, Niscola P, Perrotti AP, Arcese W (2018) Chemotherapy induced nausea and vomiting prophylaxis in high-dose melphalan and autologous stem cell transplantation. Clin Lymphoma Myeloma Leuk Article in Press. https://doi.org/10.1016/j.clml.2017.12.001

Title: Prevention of chemotherapy-induced nausea and vomiting after high-dose melphalan and stem cell transplantation: review of the evidence and suggestions
Authors: Andrea Tendas
Francesco Marchesi
Andrea Mengarelli
Ombretta Annibali
Valeria Tomarchio
Debora Saltarelli
Anna Chierichini
Mirko Di Venanzio
Fabio Sollazzo
Monica Piedimonte
Luca Cupelli
Antoine Bruno
Gottardo De Angelis
Luciano Delbono
Pasquale Niscola
Alessio Pio Perrotti
Paolo de Fabritiis
William Arcese
On behalf of Rome Transplant Network
Publication date: 01-03-2019
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 3/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4594-2

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Abstract

Introduction

Methods

Results

Conclusions

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