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International Journal of Hematology

, Volume 105, Issue 4, pp 478–484 | Cite as

Palonosetron, aprepitant, and dexamethasone for prevention of nausea and vomiting after high-dose melphalan in autologous transplantation for multiple myeloma: A phase II study

  • Atsushi Isoda
  • Rie Saito
  • Fuminori Komatsu
  • Yuki Negishi
  • Noriyasu Oosawa
  • Tetsuya Ishikawa
  • Yuri Miyazawa
  • Morio Matsumoto
  • Morio Sawamura
  • Akihiro Manaka
Original Article

Abstract

Chemotherapy-induced nausea and vomiting (CINV) is a significant side effect in multiple myeloma (MM) patients receiving high-dose melphalan treatment followed by autologous stem cell transplantation (ASCT). We evaluated the efficacy and safety of a triple antiemetic combination of palonosetron, aprepitant, and low-dose dexamethasone in 24 MM patients who received melphalan conditioning (100 mg/m2 on days 1–2) before ASCT (on day 4). Intravenous palonosetron (0.75 mg on day 1), oral aprepitant (125 mg on day 1; 80 mg on days 2–4), and intravenous dexamethasone (6.6 mg on days 1–4) were administered for prevention of CINV. Complete response (no emesis and no rescue antiemetic) and complete control (no emesis, no rescue antiemetic, and no more than mild nausea) rates were 75 and 68% during the overall phase (0–120 h), while they were 88 and 86% in the acute phase (0–48 h), 75 and 68% in the delayed phase (48–120 h), and 67 and 59% in the extended phase (120–168 h), respectively. There were no serious adverse events related to the antiemetic therapy. In conclusion, the three-antiemetic regimen consisting of palonosetron, aprepitant, and dexamethasone was safe and effective for controlling CINV due to high-dose melphalan treatment, especially during the delayed phase.

Keywords

Multiple myeloma High-dose melphalan Nausea Palonosetron Aprepitant 

Notes

Acknowledgements

The authors would like to thank Drs. Momoko Mawatari, Akio Saito, Akinori Yuzuriha, Naru Sato, and Hiroko Koya for their contributions to patient care and data collection.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Japanese Society of Hematology 2016

Authors and Affiliations

  • Atsushi Isoda
    • 1
  • Rie Saito
    • 2
  • Fuminori Komatsu
    • 2
  • Yuki Negishi
    • 2
  • Noriyasu Oosawa
    • 2
  • Tetsuya Ishikawa
    • 1
  • Yuri Miyazawa
    • 1
  • Morio Matsumoto
    • 1
  • Morio Sawamura
    • 3
  • Akihiro Manaka
    • 2
    • 4
  1. 1.Department of HematologyNational Hospital Organization Shibukawa Medical CenterShibukawaJapan
  2. 2.Department of PharmacyNational Hospital Organization Shibukawa Medical CenterShibukawaJapan
  3. 3.Department of Clinical ResearchNational Hospital Organization Shibukawa Medical CenterShibukawaJapan
  4. 4.Department of Clinical Laboratory MedicineGunma University Graduate School of MedicineMaebashiJapan

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