Sakurai, M., Mori, T., Kato, J., Koda, Y., Kikuchi, T., Kohashi, S., . . . Okamoto, S. (2014). Efficacy of aprepitant in preventing nausea and vomiting due to high-dose melphalan-based conditioning for allogeneic hematopoietic stem cell transplantation. International Journal of Hematology, 99, 457–462.
To evaluate the efficacy of aprepitant in addition to standard antiemetic therapy with ondansetron and methylprednisolone in the prevention of chemotherapy-induced nausea and vomiting (CINV) caused by high-dose melphalan given as part of conditioning for allogeneic hematopoietic stem cell transplantation (HSCT)
Retrospective, single-center analysis
Medical records during the period were analyzed to extract data about CINV and food information. Adverse events were monitored during the observation period, and there were no statistically significant differences in the incidence of grade 2 or greater adverse events between the two groups.
Aprepitant was well tolerated and positively affected the rates of delayed vomiting in this population. The ability to consume food more quickly after the conditioning regimen was improved with aprepitant.
This retrospective study did not indicate how the data were categorized from the records. There was no specific information regarding the rescue antiemetics used, and the rescue medications were chosen by the physicians. This impact on CINV was not discussed in the manuscript. The results are intriguing and demonstrate the safety of adding aprepitant, but a prospective, randomized, controlled trial will be needed to change clinical practice.