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Palonosetron versus first-generation 5-hydroxytryptamine type 3 receptor antagonists for emesis prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplantation

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Abstract

First-generation 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists (RAs) are currently the standard of care for prophylaxis against allo-HSCT-induced emesis. However, the efficacy of this combination in allo-HSCT recipients is not entirely satisfying. We sought to compare the efficacy of first-generation 5-HT3 RAs with that of second-generation 5-HT3 RAs in emesis prevention in allo-HSCT recipients. A total of 51 consecutive patients undergoing allo-HSCT for various hematological diseases in our institution were retrospectively reviewed. Patients who received daily first-generation 5-HT3 RAs, and 60-h palonosetron for emesis prophylaxis were stratified into the standard (n = 23) and palonosetron (n = 28) groups, respectively. Emesis severity and rescue therapy requirements in patients between these two groups were compared. Our results showed patients in standard and palonosetron groups had comparable severity of both acute and delayed emesis. However, 52.2 % of the patients in the standard group required rescue therapy, compared to only 21.4 % of the patients in the palonosetron group (p = 0.046). Subgroup analysis showed rescue therapy for acute emesis was required by 26.1 % of the patients in the standard group and by only 3.6 % of the patients in the palonosetron group (p = 0.037). In conclusion, palonosetron and first-generation 5-HT3 RAs were at least equally effective in emesis prophylaxis for allo-HSCT recipients. Patients receiving palonosetron, especially for acute emesis, required rescue therapy less frequently than those receiving first-generation 5-HT3 RAs.

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Conflict of interest

Chieh-Lin Jerry Teng received speaker fee from presenting data regarding palonosetron. Other authors declare that there is no conflict of interest.

Statement of informed consent

Informed consent from patients was not required for this study according to the regulation of Taichung Veterans General Hospital institutional review board.

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Authors and Affiliations

  1. Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan, 40705

    Cheng-Wei Chou, Yeh-Ku Chen, Wen-Li Hwang & Chieh-Lin Jerry Teng

  2. Division of Hematology/Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Yuan-Bin Yu

  3. Department of Medical Research and Education, Taichung Veterans General Hospital, Taichung, Taiwan

    Kuang-Hsi Chang

  4. Department of Life Science, Tunghai University, Taichung City, Taiwan

    Chieh-Lin Jerry Teng

  5. School of Medicine, Chung Shan Medical University, Taichung City, Taiwan

    Chieh-Lin Jerry Teng

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  1. Cheng-Wei Chou
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  2. Yeh-Ku Chen
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Correspondence to Wen-Li Hwang or Chieh-Lin Jerry Teng.

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Chou, CW., Chen, YK., Yu, YB. et al. Palonosetron versus first-generation 5-hydroxytryptamine type 3 receptor antagonists for emesis prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplantation. Ann Hematol 93, 1225–1232 (2014). https://doi.org/10.1007/s00277-014-2038-8

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  • DOI: https://doi.org/10.1007/s00277-014-2038-8

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