Flank, J., Thackray, J., Nielson, D., August, A., Schechter, T., Alexander, S., . . . Dupuis, L.L. (2015). Olanzapine for treatment and prevention of acute chemotherapy-induced vomiting in children: A retrospective, multi-center review. Pediatric Blood and Cancer, 62, 496–501.
To explore the efficacy and safety of olanzapine in children aged 3–17 years for chemotherapy-induced vomiting (CIV) control
This was a retrospective review of 60 children (158 chemotherapy blocks) who received olanzapine for acute CIV control at institutions in Canada and the United States over a 30-month period. All CIV data were abstracted from the childrens' health records.
Retrospective chart audit
Sixty children were given olanzapine in 128 blocks of chemotherapy on the first day of chemotherapy (usually highly emetogenic chemotherapy). Children in 125 of the 128 blocks received ondansetron or granisetron, dexamethasone (55%), or aprepitant (18%). Acute-phase CIV control was obtained in 83 (65%) blocks. There was no association between complete response and the olanzapine dose. The most commonly reported side effects were sedation (7%) and increased plasma transaminase concentrations (5%).
Olanzapine may be a useful option for CIV control in pediatric patients. However, the findings from this study were inconclusive regarding clinical efficacy.
Nurses caring for children with acute CIV should know that olanzapine in a well-monitored situation may be a safe alternative. However, its efficacy was unclear in this study. A prospective study to determine the role of olanzapine alone and in combination with other antiemetics for varied levels of emetogenicity is warranted.