Antiemetic prophylaxis regimens in haematologic malignancies patients undergoing a hematopoietic stem cell transplantation. Which is the best standard of care? A systematic review

IF 2.3 3区 医学 Q2 HEMATOLOGY
Nerea Báez-Gutiérrez, Paloma Suárez-Casillas, Maria Antonia Pérez-Moreno, Cristina Blázquez-Goñi, Laila Abdelkader-Martín
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引用次数: 0

Abstract

Introduction

This systematic review, adhering to PRISMA guidelines, aimed to evaluate the efficacy and safety of antiemetic prophylaxis in haematological patients undergoing high-dose chemotherapy as part of their hematopoietic stem cell transplantation (HSCT) conditioning regimens.

Methods

We performed a comprehensive search in PubMed, EMBASE, ClinicalTrials.gov and the Cochrane database to identify randomised controlled trials (RCTs) and systematic reviews of antiemetic prophylaxis. Studies in English, French, Italian or Spanish were included. This review is registered with PROSPERO, ID CRD42023406380.

Results

Eight RCTs were analysed. The antiemetic regimens evaluated ranged from monotherapy with 5-Hydroxytryptamine Receptor 3 antagonists (5-HT3RAs) to complex combinations including olanzapine, neurokinin-1 receptor antagonists, 5-HT3RAs and corticosteroids. Complete response rates for triplet or quadruple regimens varied between 23.5% and 81.9%. Although no significant adverse effects were observed, minor symptoms such as diarrhoea, constipation, sedation and headaches were reported.

Conclusion

Existing evidence on HSCT antiemetic therapy highlights its benefits but fails to provide clear clinical directions. The choice between triplet and quadruplet therapies for different patient scenarios is still uncertain. Until more detailed research is available, healthcare providers must rely on the latest guidelines and their judgement to customise antiemetic care for each patient's specific needs and risks.

Abstract Image

接受造血干细胞移植的血液恶性肿瘤患者的止吐预防方案。哪种疗法是最佳标准?系统综述。
导言:本系统综述遵循PRISMA指南,旨在评估作为造血干细胞移植(HSCT)调理方案一部分接受大剂量化疗的血液病患者预防性止吐的有效性和安全性:我们在 PubMed、EMBASE、ClinicalTrials.gov 和 Cochrane 数据库中进行了全面检索,以确定有关止吐药预防的随机对照试验 (RCT) 和系统综述。纳入的研究语言包括英语、法语、意大利语或西班牙语。本综述已在 PROSPERO 注册,编号为 CRD42023406380:结果:分析了 8 项研究。所评估的止吐方案既有使用5-羟色胺受体3拮抗剂(5-HT3RAs)的单一疗法,也有包括奥氮平、神经激肽-1受体拮抗剂、5-HT3RAs和皮质类固醇在内的复合疗法。三联或四联疗法的完全应答率从 23.5% 到 81.9% 不等。虽然没有观察到明显的不良反应,但也有报道称出现腹泻、便秘、镇静和头痛等轻微症状:关于造血干细胞移植止吐疗法的现有证据强调了其益处,但未能提供明确的临床指导。针对不同患者的情况,三联疗法和四联疗法之间的选择仍不确定。在获得更详细的研究结果之前,医疗服务提供者必须依靠最新的指南和自己的判断,根据每位患者的具体需求和风险定制止吐护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.50
自引率
0.00%
发文量
168
审稿时长
4-8 weeks
期刊介绍: European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.
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