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Supportive Care in Cancer

, Volume 27, Issue 3, pp 793–803 | Cite as

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

  • Andrea TendasEmail author
  • 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
Review Article
  • 79 Downloads

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.

Keywords

Chemotherapy-induced nausea and vomiting Stem cell transplantation High-dose melphalan Aprepitant Quality of life 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Andrea Tendas
    • 1
    Email author
  • Francesco Marchesi
    • 2
  • Andrea Mengarelli
    • 2
  • Ombretta Annibali
    • 3
  • Valeria Tomarchio
    • 3
  • Debora Saltarelli
    • 4
  • Anna Chierichini
    • 4
  • Mirko Di Venanzio
    • 4
  • Fabio Sollazzo
    • 5
  • Monica Piedimonte
    • 5
  • Luca Cupelli
    • 1
  • Antoine Bruno
    • 6
  • Gottardo De Angelis
    • 6
  • Luciano Delbono
    • 7
  • Pasquale Niscola
    • 1
  • Alessio Pio Perrotti
    • 1
  • Paolo de Fabritiis
    • 1
  • William Arcese
    • 6
  • On behalf of Rome Transplant Network
  1. 1.Hematology DivisionS. Eugenio HospitalRomeItaly
  2. 2.HematologyRegina Elena National Cancer InstituteRomeItaly
  3. 3.Hematology and Stem Cell Transplantation UnitUniversity Campus Bio-medicoRomeItaly
  4. 4.HematologySan Giovanni-Addolorata HospitalRomeItaly
  5. 5.HematologySant’Andrea HospitalRomeItaly
  6. 6.Hematology, Rome Transplant Network, Department of Hematology, Stem Cell Transplant UnitTor Vergata UniversityRomeItaly
  7. 7.Wake Forest University School of MedicineWinston SalemUSA

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