The aim of this study was to analyze retrospectively the multiple antiemetic combination on chemotherapy-induced nausea and vomiting (CINV) in patients receiving multiple-day and high-dose melphalan. Thirteen patients receiving 100 mg/m2 of melphalan for 2 days followed by autologous peripheral blood stem cell transplantation were surveyed.
Patients were divided into the control (5 patients) and the combination (8 patients) groups. The control regimens included 5-HT3 receptor antagonists and aprepitant, and the multiple combination regimens included dexamethasone, prochlorperazine, lorazepam, and lansoprazole added to the control regimens. CINV was assessed on Days 1-2 (acute) and on Days 3-7 (delayed).
No differences in the risk factors of CINV were observed between in the multiple combination and the control. The onset of CINV in the multiple combination, as well as the grade of CINV, was less than that in the control throughout the study period. Complete response (no emesis and rescue therapy) was observed in 50% of patients in the multiple combination. Regarding the safety of antiemetic regimens, somnolence, dizziness and dry mouth, which showed grade 1 toxicity, were observed in one patient each in the multiple combination group but not in the control group. There was no significant difference in the incidence of adverse effects between the two groups, suggesting good tolerability in the multiple combination group.
In conclusion, the multiple combination regimen of antiemetic was suggested to improve the prevention of CINV in patients receiving multiple-day and high-dose melphalan.
