Abstract
A survey within hematopoietic stem cell transplant (HSCT) centers of the Gruppo Italiano Trapianto Midollo Osseo (GITMO) was performed in order to describe current antiemetic prophylaxis in patients undergoing HSCT. The multicenter survey was performed by a questionnaire, covering the main areas on chemotherapy-induced nausea and vomiting (CINV): antiemetic prophylaxis guidelines used, antiemetic prophylaxis in different conditioning regimens, and methods of CINV evaluation. The survey was carried out in November 2016, and it was repeated 6 months after the publication of the Multinational Association of Supportive Care in Cancer (MASCC)/European Society for Medical Oncology (ESMO) specific guidelines on antiemetic prophylaxis in HSCT. The results show a remarkable heterogeneity of prophylaxis among the various centers and a significant difference between the guidelines and the clinical practice. In the main conditioning regimens, the combination of a serotonin3 receptor antagonist (5-HT3-RA) with dexamethasone and neurokin1 receptor antagonist (NK1-RA), as recommended by MASCC/ESMO guidelines, increased from 0 to 15% (before the publication of the guidelines) to 9–30% (after the publication of the guidelines). This study shows a lack of compliance with specific antiemetic guidelines, resulting mainly in under-prophylaxis. Concerted strategies are required to improve the current CINV prophylaxis, to draft shared common guidelines, and to increase the knowledge and the adherence to the current recommendations for CINV prophylaxis in the specific field of HSCT.
Similar content being viewed by others
References
Viale PH, Grande C, Moore S (2012) Efficacy and cost: avoiding under treatment of chemotherapy-induced nausea and vomiting. Clin J Oncol Nurs 16:E133–E141. https://doi.org/10.1188/12.CJON.E133-E141
Vidall C, Sharma S, Amlani B (2016) Patient-practioner perception gap in treatment-induced nausea and vomiting. Br J Nurs 25(16):S4–S1
Fernández-Ortega P, Caloto MT, Chirveches E, Marquilles R, Francisco JS, Quesada A, Suárez C, Zorrilla I, Gómez J, Zabaleta P, Nocea G, Llombart-Cussac A. (2012) Chemotherapy-induced nausea and vomiting in clinical practice: impact on patients’ quality of life. 20(12):3141-8, DOI: https://doi.org/10.1007/s00520-012-1448-1
Larsen J, Nordstrom G, Ljungman P, Gardulf A (2004) Symptom occurrence, symptom intensity, and symptom distress in patients undergoing high-dose chemotherapy with stem-cell transplantation. Cancer Nurs 27(1):55–64. https://doi.org/10.1094/PHYTO.2004.94.4.320
Grulke N, Albani C, Bailer H (2012) Quality of life in patients before and after haematopoietic stem cell transplantation measured with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire QLQ-C30. Bone Marrow Transplant 47(4):473–482. https://doi.org/10.1038/bmt.2011.107
Kris MG, Hesketh PJ, Somerfield MR, Feyer P, Clark-Snow R, Koeller JM et al (2006) American Society of Clinical Oncology guideline for antiemetics in oncology: update 2006. J Clin Oncol 24(18):2932–2947. https://doi.org/10.1200/JCO.2006.06.9591
Einhorn LH, Rapoport B, Navari RM, Herrstedt J, Brames JM (2017) 2016 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following multiple-day chemotherapy, and breakthrough nausea and vomiting. Support Care Cancer 25:303–308. https://doi.org/10.1007/s00520-016-3449-y
Stiff PJ, Fox-Geiman MP, Kiley K, Rychlik K, Parthasarathy M, Fletcher-Gonzales D et al (2013) Prevention of nausea and vomiting associated with stem cell transplantation: results of a prospective, randomized trial of aprepitant used with highly emetogenic preparative regimen. Biol Blood Marrow Transplant 19:49–55. https://doi.org/10.1016/j.bbmt.2012.07.019
Svanberg A, Biregard G (2015) Addition of aprepitant (Emend) to standard antiemetic regimen continued for 7 days after chemotherapy for stem cell transplantation provides significant reduction of vomiting. Oncology 89:31–36. https://doi.org/10.1159/000371523
Schmitt T, Goldschmidt H, Neben K, Freiberger A, Husing J, Gronkowski M et al (2014) Aprepitant, granisetron, and dexamethasone for prevention of chemotherapy-induced nausea and vomiting after high-dose melphalan in autologous transplantation for multiple myeloma: results of a randomized, placebo-controlled phase III trial. J Clin Oncol 32:3413–3420. https://doi.org/10.1200/JCO.2013.55.0095
Roila F, Herrstedt J, Aapro M, Gralla RJ, Einhorn LH, Ballatori E, Bria E, Clark-Snow RA, Espersen BT, Feyer P et al (2010) Guideline update for MASCC and ESMO in the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference. Ann Oncol 21(Suppl 5):v232–v243
NCCN Clinical Practice Guidelines in Oncology; Antiemesis. (Version 2.2015)
NCCN Clinical Practice Guidelines in Oncology; Antiemesis. (Version 1.2019)
Hesketh PJ, Kris MG, Basch E, Bohlke K, Barbour SY, Clark-Snow RA et al (2017) Antiemetics: American Society of Clinical Oncology practice guideline update. J Clin Oncol 35:3240–3261
Hesket PJ, Bohlke K, Lyman GH, Basch E, Chesney M, Clark-Snow RA et al (2015) Antiemetics: American Society of Clinical Oncology focused guideline update. J Clin Oncol 34:381–386
Pielichowski W, Barzal J, Gawronski K, Mlot B, Wasko-Grabowska A, Rzepecki P et al (2011) A triple-drug combination to prevent nausea and vomiting following BEAM chemotherapy before autologous hematopoietic stem cell transplantation. Transplant Proc 43:3107–3110. https://doi.org/10.1016/j.transproceed.2011.08.010
Pielichowski W, Gawronski K, Mlot B, Oborska S, Wasko-Grabowska A, Rzepecki P (2011) Triple drug combination in the prevention of nausea and vomiting following busulfan plus cyclophosphamide chemotherapy before allogeneic hematopoietic stem cell transplantation. J BUON 16:541–546
Bechtel T, McBride A, Crawford B, Bullington S, Hofmeister CC, Benson DM et al (2014) Aprepitant for the control of delayed nausea and vomiting associated with the use of high-dose melphalan for autologous peripheral blood stem cell transplants in patients with multiple myeloma: a phase II study. Support Care Cancer 22:2911. https://doi.org/10.1007/s00520-014-2248-6
Uchida M, Ikesue H, Miyamoto T, Kato K, Suetsugu K, Ikinose K et al (2013) Effectiveness and safety of antiemetic aprepitant in Japanese patients receiving high-dose chemotherapy prior to autologous hematopoietic stem cell transplantation. Biol Pharm Bull 36:819–824. https://doi.org/10.1248/bpb.b12-01012
Sakurai M, Mori T, Kato J, Koda Y, Kikuchi T, Kohashi S et al (2014) Efficacy of aprepitant in preventing nausea and vomiting due to high-dose melphalan-based conditioning for allogeneic hematopoietic stem cell transplantation. Int J Hematol 99:457–462. https://doi.org/10.1007/s12185-014-1538-6
Aapro M, Molassiotis A, Dicato M, Peláez I, Rodríguez-Lescure Á, Pastorelli D et al (2012) The effect of guideline-consistent antiemetic therapy on chemotherapy-induced nausea and vomiting (CINV): the Pan European Emesis Registry (PEER). Ann Oncol 8:1986–1992
Gilmore JW, Peacock NW, Gu A, Szabo S, Rammage M, Sharpe J et al (2013) Antiemetic guideline consistency and incidence of chemotherapy-induced nausea and vomiting in US community oncology practice: INSPIRE Study. J Oncol Pract 10:68–74
Rapaport B, Smit T (2017) Clinical pharmacology of neurokinin-1 receptor antagonists for the treatment of nausea and vomiting associated with chemotherapy. Expert Opin Drug Saf 16:697–710. https://doi.org/10.1080/14740338.2017.1325868
Chawla SP, Grunberg SM, Gralla RJ et al (2003) Establishing the dose of the oral NK1antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting. Cancer 97:2290–2300. https://doi.org/10.1002/cncr.11320
Trifilio S, Welles C, Seeger K, Mehta S, Fishman M, McGowan K et al (2017) Olanzapine reduces chemotherapy-induced nausea and vomiting compared with aprepitant in myeloma patients receiving high-dose melphalan before stem cell transplantation: a retrospective study. Clin Lymphoma Myeloma Leuk 17(9):584–589. https://doi.org/10.1016/j.clml.2017.06.012
Clemmons AB, Orr J, Andrick B, Gandhi A, Sportes C, DeRemer D (2018) Randomized, placebo-controlled, phase III trial of fosaprepitant, ondansetron, dexamethasone (FOND) versus FOND plus olanzapine (FOND-O) for the prevention of chemotherapy-induced nausea and vomiting in patients with hematologic malignancies receiving highly emetogenic chemotherapy and hematopoietic cell transplantation regimens: the FOND-O trial. Biol Blood Marrow Transplant 24(10):2065–2071
Grunberg S, Chua D, Maru A et al Single-dose fosaprepitant for the prevention of chemotherapy induced nausea and vomiting associated with cisplatin therapy: randomized, double-blind study protocol—EASE. J Clin Oncol 29:1495–1501. https://doi.org/10.1200/JCO.2010.31.7859
Lasseter KC, Gambale J, Jin B, Bergman A, Constanzer M, Dru J, Han TH, Majumdar A, Evans JK, Murphy MG (2007) Tolerability of fosaprepitant and bioequivalency to aprepitant in healthy subjects. J Clin Pharmacol 47:834–840. https://doi.org/10.1177/0091270007301800
Clark SM, Clemmons AB, Schaack L, Garren J, DeRemer DL, Kota VK (2016) Fosaprepitant for the prevention of nausea and vomiting in patients receiving BEAM or high-dose melphalan before autologous hematopoietic stem cell transplant. J Oncol Pharm Pract 22(3):416–422
Gralla RJ, Bosnjak SM, HontsaAet al. (2014) A phase III study evaluating the safety and efficacy of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting over repeated cycles of chemotherapy. Ann Oncol 25:1333–1339. https://doi.org/10.1093/annonc/mdu096
Hesketh PJ, Rossi G, Rizzi G, Palmas M, Alyasova A, Bondarenko I, Lisyanskaya A, Gralla RJ (2014) Efficacy and safety of NEPA, an oral combination of netupitant and palonosetron, for prevention of chemotherapy induced nausea and vomiting following highly emetogenic chemotherapy: a randomized dose ranging pivotal study. Ann Oncol 25:1340–1346. https://doi.org/10.1093/annonc/mdu110
Aapro M, Rugo H, Rossi G et al (2014) A randomized phase III study evaluating the efficacy and safety of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy. Ann Oncol 25:1328–1333. https://doi.org/10.1093/annonc/mdu101
Rapoport BL, Chasen MR, Gridelli C, Urban L, Modiano MR, Schnadig ID, Poma A, Arora S, Kansra V, Schwartzberg LS, Navari RM (2015) Safety and efficacy of rolapitant for prevention of chemotherapy-induced nausea and vomiting after administration of cisplatin-based highly emetogenic chemotherapy in patients with cancer: two randomised, active-controlled, double-blind, phase 3 trials. Lancet Oncol 16(9):1079–1089
Schwartzberg LS, Modiano MR, Rapoport BL, Chasen MR, Gridelli C, Urban L, Poma A, Arora S, Navari RM, Schnadig ID (2015) Safety and efficacy of rolapitant for prevention of chemotherapy-induced nausea and vomiting after administration of moderately emetogenic chemotherapy or anthracycline and cyclophosphamide regimens in patients with cancer: a randomised, active-controlled, double-blind, phase 3 trial. Lancet Oncol 16(9):1071–1078
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Ethical approval
This article does not contain any studies with human participants or animal by any of the authors.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
ESM 1
(DOCX 19.8 kb)
Rights and permissions
About this article
Cite this article
Pastore, D., Bruno, B., Carluccio, P. et al. Antiemetic prophylaxis in patients undergoing hematopoietic stem cell transplantation: a multicenter survey of the Gruppo Italiano Trapianto Midollo Osseo (GITMO) transplant programs. Ann Hematol 99, 867–875 (2020). https://doi.org/10.1007/s00277-020-03945-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00277-020-03945-3