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08.02.2020 | Original Article

Antiemetic prophylaxis in patients undergoing hematopoietic stem cell transplantation: a multicenter survey of the Gruppo Italiano Trapianto Midollo Osseo (GITMO) transplant programs

Zeitschrift:
Annals of Hematology
Autoren:
Domenico Pastore, Benedetto Bruno, Paola Carluccio, Maria Stella De Candia, Sonia Mammoliti, Carlo Borghero, Anna Chierichini, Fabio Pavan, Marco Casini, Massimo Pini, Luca Nassi, Raffaella Greco, Francesco Paolo Tambaro, Paola Stefanoni, Giuseppe Console, Francesco Marchesi, Luca Facchini, Alberto Mussetti, Michele Cimminiello, Francesco Saglio, Daniele Vincenti, Sadia Falcioni, Patrizia Chiusolo, Jacopo Olivieri, Annalisa Natale, Maura Faraci, Simone Cesaro, Serena Marotta, Anna Proia, Irene Donnini, Daniela Caravelli, Eliana Zuffa, Anna Paola Iori, Elena Soncini, Valentina Bozzoli, Giovanni Pisapia, Renato Scalone, Oreste Villani, Arcangelo Prete, Antonella Ferrari, Mariacristina Menconi, Giorgia Mancini, Federica Gigli, Gianpaolo Gargiulo, Barbara Bruno, Francesca Patriarca, Francesca Bonifazi
Wichtige Hinweise

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The online version of this article (https://​doi.​org/​10.​1007/​s00277-020-03945-3) contains supplementary material, which is available to authorized users.

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Abstract

A survey within hematopoietic stem cell transplant (HSCT) centers of the Gruppo Italiano Trapianto Midollo Osseo (GITMO) was performed in order to describe current antiemetic prophylaxis in patients undergoing HSCT. The multicenter survey was performed by a questionnaire, covering the main areas on chemotherapy-induced nausea and vomiting (CINV): antiemetic prophylaxis guidelines used, antiemetic prophylaxis in different conditioning regimens, and methods of CINV evaluation. The survey was carried out in November 2016, and it was repeated 6 months after the publication of the Multinational Association of Supportive Care in Cancer (MASCC)/European Society for Medical Oncology (ESMO) specific guidelines on antiemetic prophylaxis in HSCT. The results show a remarkable heterogeneity of prophylaxis among the various centers and a significant difference between the guidelines and the clinical practice. In the main conditioning regimens, the combination of a serotonin3 receptor antagonist (5-HT3-RA) with dexamethasone and neurokin1 receptor antagonist (NK1-RA), as recommended by MASCC/ESMO guidelines, increased from 0 to 15% (before the publication of the guidelines) to 9–30% (after the publication of the guidelines). This study shows a lack of compliance with specific antiemetic guidelines, resulting mainly in under-prophylaxis. Concerted strategies are required to improve the current CINV prophylaxis, to draft shared common guidelines, and to increase the knowledge and the adherence to the current recommendations for CINV prophylaxis in the specific field of HSCT.

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