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带有草莓香气的棒棒糖在减少冷冻保存外周血干细胞输注过程中与输注相关的恶心和呕吐方面可能很有前景。

The lollipop with strawberry aroma may be promising in reduction of infusion-related nausea and vomiting during the infusion of cryopreserved peripheral blood stem cells.

作者信息

Ozdemir Evren, Akgedik Kiymet, Akdogan Sadiye, Kansu Emin

机构信息

Hacettepe University Institute of Oncology, Stem Cell Transplantation Unit, Ankara, Turkey.

出版信息

Biol Blood Marrow Transplant. 2008 Dec;14(12):1425-8. doi: 10.1016/j.bbmt.2008.09.010.

Abstract

Nausea and vomiting during the infusion of cryopreserved peripheral blood stem cells (PBSC) are common. The aim of this study was to explore the effect of lollipop with strawberry aroma on the infusion-related nausea and vomiting of cryopreserved autologous PBSCs. We compared 2 groups of adult patients receiving lollipop with strawberry aroma during cryopreserved PBSC infusions or not to assess the incidences of nausea and vomiting occurring during infusions. All patients received granisetron 3 mg i.v. twice a day, and lorazepam 1 mg every 4 hours orally for prophylaxis of the nausea and vomiting during conditioning phase and infusion day. Before infusion, all patients were premedicated with pheniramine maleate 45.5 mg i.v. and paracetamol 500 mg orally. The patients had no evidence of nausea or vomiting prior to cryopreserved PBSC infusions. The patients with ongoing nausea or vomiting owing to conditioning regimens and/or receiving additional antiemetics were excluded from the study. One hundred fifty-eight patients who consecutively underwent autologous stem cell transplantation for malignancy were included in the study. The first 110 patients (median age: 42.5, range: 17-75) were observed for the infusion related adverse effects only. The consecutive 48 patients (median age: 48, range: 18-80) were given a lollipop with strawberry aroma during cryopreserved PBSC infusions and observed for the infusion-related adverse effects. The 2 groups were comparable with respect to age, sex, diagnosis, stem cell collection methods, conditioning regimens administered, total mononuclear cell dose infused, number of total nucleated cells (TNCs) infused, number of CD34+ cells infused, number of bags infused, total volume infused, amount of dimethylsulfoxide (DMSO), and infusion rate. Patients who received a lollipop with a strawberry aroma during infusions had significantly less nausea (6.3%, n = 3 versus 21.8%, n = 24, P = .02) and vomiting (2%, n = 1 versus 13.6%, n = 15, P = .04) than the ones who did not (observation only group). Other infusion-related adverse events were as follows; hypoxia, cough, dyspnea, abdominal cramping, tachycardia, hiccup, fever, chills, chest pain, hypotension, hypertension, agitation, sore throat, and arrhythmia. Incidences of each of these adverse events were <5% in both groups and were comparable. The use of a lollipop with a strawberry aroma during infusion of cryopreserved autologous PBSCs may be promising in reduction of infusion-related nausea and vomiting, with an easy administration at a very cheap cost.

摘要

在输注冷冻保存的外周血干细胞(PBSC)过程中,恶心和呕吐很常见。本研究的目的是探讨草莓香味棒棒糖对冷冻保存的自体PBSC输注相关恶心和呕吐的影响。我们比较了两组成年患者,一组在冷冻保存的PBSC输注期间接受草莓香味棒棒糖,另一组不接受,以评估输注期间恶心和呕吐的发生率。所有患者在预处理阶段和输注日接受3mg静脉注射格拉司琼,每日两次,以及每4小时口服1mg劳拉西泮,以预防恶心和呕吐。在输注前,所有患者静脉注射45.5mg马来酸氯苯那敏和口服500mg对乙酰氨基酚进行预处理。患者在冷冻保存PBSC输注前无恶心或呕吐迹象。因预处理方案导致持续恶心或呕吐和/或接受额外止吐药的患者被排除在研究之外。158例连续接受恶性肿瘤自体干细胞移植的患者纳入研究。前110例患者(中位年龄:42.5岁,范围:17 - 75岁)仅观察输注相关不良反应。连续48例患者(中位年龄:48岁,范围:18 - 80岁)在冷冻保存的PBSC输注期间给予草莓香味棒棒糖,并观察输注相关不良反应。两组在年龄、性别、诊断、干细胞采集方法、所给予的预处理方案、输注的总单核细胞剂量、输注的总核细胞(TNC)数量、输注的CD34 +细胞数量、输注的袋数、输注的总体积、二甲基亚砜(DMSO)量和输注速率方面具有可比性。在输注期间接受草莓香味棒棒糖的患者恶心(6.3%,n = 3对比21.8%,n = 24,P = 0.02)和呕吐(2%,n = 1对比13.6%,n = 15,P = 0.04)明显少于未接受的患者(仅观察组)。其他输注相关不良事件如下:缺氧、咳嗽、呼吸困难、腹部绞痛、心动过速、打嗝、发热、寒战、胸痛、低血压、高血压、烦躁、喉咙痛和心律失常。两组中这些不良事件的发生率均<5%,且具有可比性。在冷冻保存的自体PBSC输注期间使用草莓香味棒棒糖在减少输注相关恶心和呕吐方面可能很有前景,且给药简便、成本极低。

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