AI Article Synopsis
- HDMel is the primary chemotherapy for autologous stem cell transplantation in multiple myeloma patients, but there's no consensus on preventing chemotherapy-induced nausea and vomiting (CINV).
- Data from eleven studies shows that HDMel is generally considered a moderate to high emetogenic risk, with varying prophylaxis strategies.
- An aprepitant-based three-drug regimen is recommended for better CINV prevention compared to a two-drug regimen, as it effectively reduces nausea without increasing adverse side effects.
Article 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.
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| http://dx.doi.org/10.1007/s00520-018-4594-2 | DOI Listing |
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