Nadaraja, S., Mamoudou, A.D., Thomassen, H., Wehner, P.S., Rosthoej, S., & Schroeder, H. (2012). Palonosetron for the prevention of nausea and vomiting in children with acute lymphoblastic leukemia treated with high dose methotrexate. Pediatric Blood & Cancer, 59, 870–873.
To examine the effect of a single dose of palonosetron for the prevention of chemotherapy-induced nausea and vomiting (CINV) in children 18 years of age and younger with acute lymphoblastic leukemia (ALL) treated with high-dose methotrexate (HD MTX) (5 g/m2)
This study was a prospective analysis of the effectiveness of palonosetron given as a single dose (5 mcg/kg) prior to the administration of HD MTX in children 18 years or younger with ALL. Both MTX-naïve patients and previously treated patients were included. Data was collected on 138 courses of chemotherapy with a total of 53 patients. Response was determined by patient/parent questionnaires and patient records. Authors described the questionnaires as reporting the occurrence of emesis, the intensity of nausea, and the use of rescue therapy at six-hour intervals from day 1 until discharge. Intensity of nausea was measured using a visual analogue score (VAS) ranging from 0 to 10. Complete response was defined as no emetic episodes and no use of rescue medications during the acute phase (0–24 hours) and the delayed phase (24–66 hours).
This was a multi-site study conducted in Denmark.
This was a prospective trial.
This study demonstrated that a single dose of palonosetron was effective in the prevention of CINV in children 18 years old and younger with ALL receiving HD MTX both in the acute and delayed phases.
Palonosetron has been effective for moderate to highly emetogenic chemotherapy in acute and delayed CINV in adults. This study demonstrated that a single dose of palonosetron was effective in preventing both acute and delayed phase CINV in the majority of children under age 18 with ALL receiving HD MTX. Prospective randomized controlled trials should be conducted in other pediatric oncology populations to determine generalizability of these findings.