The burden of chemotherapy-induced nausea and vomiting in children receiving hematopoietic stem cell transplantation conditioning: a prospective study

Abstract

This prospective study describes chemotherapy-induced nausea and vomiting (CINV) in children (4-18 years) receiving their first hematopoietic stem cell transplant. Emetic episodes, nausea severity (assessed using a validated, self-report nausea severity assessment tool) and antiemetic administration were documented from the start of conditioning until 24 h after the last conditioning agent was administered (acute) and for a further 7 days (delayed). Relationships between CINV control and parenteral nutrition (PN) use and acute gut GvHD (aGvHD) were explored. Fifty-nine children (4.6-17.4 years) were evaluable. Complete chemotherapy-induced vomiting (CIV; acute: 24%; delayed 22%) and chemotherapy-induced nausea (CIN; acute 7%; delayed 12%) control rates were low. Few children experienced complete CINV control (no vomiting/retching and no nausea) during the acute (5%) or delayed phases (12%). Children experiencing complete acute or delayed CIN control or complete delayed CIV control were more likely to have received: a lower proportion of their total energy requirement as PN at the end of the delayed phase (P<0.036) and PN for a shorter time (P<0.044). Low patient numbers did not permit evaluation of the association between gut aGvHD and CINV control. Effective and safe interventions aimed at improving CINV control in children are required.

Classification of the acute emetogenicity of chemotherapy in pediatric patients: A clinical practice guideline

“…First, the emetogenicity of IV busulfan has been changed from moderate to high. This was based on a prospective study in 16 pediatric patients . Second, the emetogenicity classification of doxorubicin now varies based on dose (Table ).…”

Acupressure to Reduce Treatment-Related Symptoms for Children With Cancer and Recipients of Hematopoietic Stem Cell Transplant: Protocol for a Randomized Controlled Trial

“…Additional data show that effective management of nausea and vomiting in children remains challenging. 3,96 This trial will provide data on an integrative medicine approach to improve symptom management.…”

“…Despite advances in pharmacologic symptom management, most children with cancer 1,2 or receiving a hematopoietic stem cell transplant (HSCT) [3][4][5][6] suffer from multiple treatment-related symptoms including nausea, vomiting, 7 pain, 8 and fatigue. 3 Pharmacologic symptom management can be effective, but can have side effects that decrease quality of life. 9,10 Symptom distress is an important predictor of poor health-related quality of life among children treated for cancer 11 or receiving HSCT.…”

Acupressure bands do not improve chemotherapy‐induced nausea control in pediatric patients receiving highly emetogenic chemotherapy: A single‐blinded, randomized controlled trial

“…Evaluation of CIN in pediatric patients has only recently been possible through the development and validation of pediatric, self‐report measures like the Pediatric Nausea Assessment Tool (PeNAT) . Recent studies indicate that almost all pediatric patients receiving highly emetogenic chemotherapy (HEC) experience CIN …”

“…2 Recent studies indicate that almost all pediatric patients receiving highly emetogenic chemotherapy (HEC) experience CIN. 3,4 Many patients and families are interested in using nonpharmacologic therapies to control symptoms. 5 Acupuncture and acupressure are traditional Chinese medicine techniques that seek to improve health by regulating basal energy through acupoint stimulation.…”