Olanzapine reduces chemotherapy induced nausea and vomiting compared to aprepitant in myeloma patients receiving high-dose melphalan prior to stem cell transplantation: A retrospective study

Publication date: Available online 20 June 2017 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Steven Trifilio, Colleen Welles, Kristin Seeger, Shivani Mehta, MaryAnne Fishman, Katherine McGowan, Kathryn Strejcek, Emily Eiten, Carolyn Pirotte, Elizabeth Lucier, Sean DeFrates, Jayesh Mehta Introduction Acute and delayed chemotherapy induced nausea and vomiting (CINV) occurs in most patients who receive high dose melphalan (HDM) and significantly affects quality of life during autologous stem cell transplantation (HSCT). Faced with unsatisfactory results with an aprepitant based regimen , an olanzapine-based regimen was initiated, with the hope of improving acute and delayed CINV . A retrospective study was conducted to compare the effectiveness of olanzapine versus aprepitant based regimens for CINV prevention in adult hematopoetic stem cell recipients who received high dose melphalan. Methods We compared olanzapine (n=43), with aprepitant (n=54) or fosaprepitant (n=20). Olanzapine was given orally 5mg twice daily for 5 days , aprepitant 125mg on day-1, and 80mg day 0,1 and fosaprepitant 150mg on day-1. The dose of 2 concomitant drugs (dexamethasone and 5-hydroxytryptamine type 3–receptor antagonist) was similar in the two groups. Nausea prevention was the primary end point; a complete response (CR) based upon a composite index of no emesis and no use of rescue medications was the secondary end point. Results The results show olanzapine significantl...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research