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Are orange lollies effective in preventing nausea and vomiting related to dimethyl sulfoxide? A multicenter randomized trial

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Abstract

Purpose

Nausea and vomiting (NV) related to DMSO affect patients undergoing auto-SCT despite antiemetic measures. Orange flavoring may reduce gastrointestinal symptoms.

Methods

A multicenter, randomized, three-arm, open-label trial in four Italian large bone marrow transplant centers was conducted to assess the effectiveness of orange aroma in preventing NV related to DMSO. Patients were randomized to orange ice lollies, non-citrus ice lollies, and routine treatment (deep breaths) during reinfusion. Data on NV were collected up to 5 days after infusion; 69/98 patients were randomized: 23 to orange, 21 to non-citrus ice lollies, and 25 to routine treatment.

Results

Although 48 h after transplantation no differences were observed in controlled nausea (Numerical Rating Scale (NRS) 0–100, ≤25) or vomiting, significantly fewer patients had no episodes of vomiting, no antiemetic rescue therapy, and no nausea (NRS <5) in the deep breath vs lollies groups (P = 0.017). The intensity of nausea over time differed significantly between ice lollies vs routine care (P = 0.001) groups, but not between the orange and non-citrus groups (P = 0.428).

Conclusion

The vasoconstrictive action of ice may prevent NV related to DMSO in the acute phase and reduce the need for rescue antiemetic therapy. Ice lollies offer a simple, noninvasive, and economic means for relieving nausea and vomiting related to this preservative.

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References

  1. Gratwohl A, Baldomero H, Aljurf M, Pasquini MC, Bouzas LF, Yoshimi A et al (2010) Hematopoietic stem cell transplantation: a global perspective. JAMA 303:1617–1624. doi:10.1001/jama.2010.491

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Sauer-Heilborn A, Kadidlo D, McCullough J (2004) Patient care during infusion of hematopoietic progenitor cells. Transfusion 44:907–916. doi:10.1111/j.1537-2995.2004.03230.x

    Article  PubMed  Google Scholar 

  3. Santos NC, Figueria-Coelho J, Martins-Silva J, Saldanha C (2003) Multidisciplinary utilization of dimethyl sulfoxide: pharmacological, cellular and molecular aspects. Biochem Pharmacol 65:1035–1041. doi:10.1016/S0006-2952(03)00002-9

    Article  CAS  PubMed  Google Scholar 

  4. Horacek JM, Jebavy L, Jakl M, Zak P, Mericka P, Maly J (2009) Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients—impact of cryopreservation with dimethylsulfoxide. Exp Oncol 31:121–122

    CAS  PubMed  Google Scholar 

  5. Prior D, Mitchell A, Nebauer M, Smith M (2000) Oncology nurses’ experience of dimethyl sulfoxide odor. Cancer Nurs 23:134–140

    Article  CAS  PubMed  Google Scholar 

  6. Potter P, Eisenberg S, Cain KC, Berry DL (2011) Orange interventions for symptoms associated with dimethyl sulfoxide during stem cell reinfusions. Cancer Nurs 34:361–368. doi:10.1097/NCC.0b013e31820641a5

    Article  PubMed  Google Scholar 

  7. Cox MA, Kastrup J, Hrubisko M (2012) Historical perspectives and the future of adverse reactions associated with haemopoietic stem cell cryopreserved with dimethyl sulfoxide. Cell Tissue Bank 13:203–215. doi:10.1007/s10561-011-9248-2

    Article  CAS  PubMed  Google Scholar 

  8. Bakken AM (2006) Cryopreserving human peripheral blood progenitor cells. Curr Stem Cell Res Ther 1:47–54. doi:10.2174/157488806775269179

    Article  CAS  PubMed  Google Scholar 

  9. Abrahamsen JF, Bakken AM, Bruserud O (2002) Cryopreserving human peripheral blood progenitors cells with 5 percent rather than 10 percent DMSO results in less apoptosis and necrosis in CD34+ cells. Transfusion 42:1573–1580. doi:10.1046/j.1537-2995.2002.00242.x

    Article  CAS  PubMed  Google Scholar 

  10. Curcoy AI, Alcorta I, Estella J, Rives S, Toll T, Tuset E (2002) Cryopreservation of HPCs with high cell concentration in 5 percent DMSO for transplantation to children [letter]. Transfusion 42:962. doi:10.1046/j.1525-1438.2002.00198.x

    Article  PubMed  Google Scholar 

  11. Ndao DH, Ladas EJ, Cheng B, Sands SA, Snyder KT, Garvin JH Jr et al (2012) Inhalation aromatherapy in children and adolescents undergoing stem cell infusion: results of a placebo-controlled double-blind trial. Psycho-Oncology 21:247–254. doi:10.1002/pon.1898

    Article  PubMed  Google Scholar 

  12. Lopez-Jiménez J, Martin-Ballesteros E, Sureda A, Uralburo C, Lorenzo I, Del Campo R et al (2006) Chemotherapy-induced nausea and vomiting in acute leukemia and stem cell transplant patients: result of a multi-center observational study. Haematologica 91:84–91

    PubMed  Google Scholar 

  13. Comeau TB, Epstein JB, Migas C (2001) Taste and smell dysfunction in patients receiving chemotherapy: a review of current knowledge. Support Care Cancer 9:575–580. doi:10.1007/s005200100279

    Article  CAS  PubMed  Google Scholar 

  14. Takahashi YK, Nagayama S, Mori K (2004) Detection and masking of spoiled food smells by odor maps in the olfactory bulb. J Neurosci 24:8690–8694. doi:10.1523/JNEUROSCI.2510-04.2004

    Article  CAS  PubMed  Google Scholar 

  15. Aungst JL, Heyward PM, Puche AC, Karnup SV, Hayar A, Szabo G et al (2003) Centre-surround inhibition among olfactory bulb glomeruli. Nature 426:623–629. doi:10.1038/nature02185

    Google Scholar 

  16. Nagayama S, Takahashi YK, Yoshihara Y, Mori K (2004) Mitral and tufted cell differ in the decoding manner of odor maps in the rat olfactory bulb. J Neurophysiol 91:2532–2540. doi:10.1152/jn.01266.2003

    Article  PubMed  Google Scholar 

  17. Dallal GE. Randomization.com. http://www.randomization.com. Accessed 31 May 2012

  18. Wang GW, Hu WT, Huang BK, Qin LP (2011) Illicium verum: a review on its botany, traditional use, chemistry and pharmacology. J Ethnopharmacol 136:10–20. doi:10.1016/j.jep.2011.04.051

    Article  CAS  PubMed  Google Scholar 

  19. Zung WWK (1971) A rating instrument for anxiety disorders. Psychosomatics 12:371–379. doi:10.1016/S0033-3182(71)71479-0

    Article  CAS  PubMed  Google Scholar 

  20. Hesketh PJ (1999) Defining the emetogenicity of cancer chemotherapy regimens: relevance to clinical practice. Oncologist 4:191–196

    CAS  PubMed  Google Scholar 

  21. Harrell FE (2001) Regression modeling strategies with applications to linear model, logistic regression and survival analysis. Springer, New York

    Google Scholar 

  22. R Core Team (2012) R: a language and environment for statistical computing. R Foundation for Statistical Computing. ISBN 3-900051-07-0. http://www.R-project.org/

  23. Blijlevens N (2007) Cytotoxic treatment-induced gastrointestinal symptoms. Curr Opin Support Palliat Care 1:16–22. doi:10.1097/SPC.0b013e3281108025

    Article  PubMed  Google Scholar 

  24. Sonis S, Elting L, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M et al (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology and consequences for patients. Cancer 100(Suppl 9):1995–2025. doi:10.1002/cncr.20162

    Article  PubMed  Google Scholar 

  25. Vokurka S, Bystricka E, Koza V, Scudlova J, Pavlicova V, Valentova D et al (2006) Higher incidence of chemotherapy induced oral mucositis in females: a supplement of multivariate analysis to a randomized multicentre study. Support Care Cancer 14:974–976. doi:10.1007/s00520-006-0031-z

    Article  PubMed  Google Scholar 

  26. Grazziutti ML, Dong L, Miceli MH, Krishna SG, Kiwan E, Syed N et al (2006) Oral mucositis in myeloma patients undergoing melphalan-based autologous stem cell transplantation: incidence, risk factors and a severity predictive model. Bone Marrow Transplant 38:501–506. doi:10.1038/sj.bmt.1705471

    Article  CAS  PubMed  Google Scholar 

  27. Costa LJ, Micallef IN, Inwards DJ, Johnston PB, Porrata LF, Litzow MR et al (2008) Effect of the dose per body weight of conditioning chemotherapy on severity of mucositis and risk of relapse after autologous haematopoietic stem cell transplantation in relapsed diffuse large B cell lymphoma. BJH 143:268–273. doi:10.1111/j.1365-2141.2008.07342.x

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

Our thanks to nurses for helping identify potential participants and for data collection, but especially the study participants who agreed to try the intervention even during a time of illness. This work was supported by Fondazione Neoplasie Sangue Onlus (FO.NE.SA).

Conflict of interest

The authors have no conflict of interest to declare.

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Correspondence to Silvia Gonella.

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Gonella, S., Berchialla, P., Bruno, B. et al. Are orange lollies effective in preventing nausea and vomiting related to dimethyl sulfoxide? A multicenter randomized trial. Support Care Cancer 22, 2417–2424 (2014). https://doi.org/10.1007/s00520-014-2227-y

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  • DOI: https://doi.org/10.1007/s00520-014-2227-y

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