Hsu Grace, Bernhardi Ciera, Lawson Justin, Duong Vu H, Emadi Ashkan, Niyongere Sandrine, Duffy Alison
Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA.
School of Medicine, University of Maryland School, Baltimore, MD, USA.
J Oncol Pharm Pract. 2024 Oct;30(7):1186-1192. doi: 10.1177/10781552231205824. Epub 2023 Oct 10.
Olanzapine use for chemotherapy-induced nausea and vomiting (CINV) in hematological malignancies, for multi-day chemotherapy, and with a steroid-sparing antiemetic strategy is poorly understood. This study investigated if olanzapine is associated with improved prevention of CINV when added to a steroid-sparing antiemetic regimen in patients with acute leukemia receiving intensive, moderately emetogenic, multi-day chemotherapy.
This was a single-center, retrospective cohort study in patients with acute leukemia. Patients who received olanzapine for CINV prevention were compared to those who did not. All patients received a 5-HT3 antagonist. Adult patients receiving moderately emetogenic, multi-day, intensive chemotherapy for acute leukemia were included. Patients were excluded if they received steroids greater than physiological doses during the study period. The primary endpoint was the complete response of CINV (no emesis or rescue antiemetic usage).
This study included 58 patients, 12 patients received olanzapine and 46 patients were in the control group. Baseline demographics were similar. In the study population, 89.7% had acute myeloid leukemia, median age was 54 (interquartile range 42-63) years, 34.5% were female, 27.6% had prior CINV. Complete response of CINV was similar between groups, 4 (33.3%) and 15 (32.6%) patients in the olanzapine and control groups, respectively. Safety events were similar between groups.
Patients with acute leukemia receiving multi-day intensive chemotherapy are at high risk for CINV. The limited data in this study suggests that olanzapine use within a steroid-sparing antiemetic regimen was well tolerated and associated with similar incidence and severity of CINV compared to the control group.
奥氮平用于血液系统恶性肿瘤化疗引起的恶心和呕吐（CINV）、多日化疗以及采用节省类固醇的止吐策略的情况目前了解较少。本研究调查了在接受强化、中度致吐性多日化疗的急性白血病患者中，将奥氮平添加到节省类固醇的止吐方案中是否与改善CINV的预防相关。
这是一项针对急性白血病患者的单中心回顾性队列研究。将接受奥氮平预防CINV的患者与未接受奥氮平的患者进行比较。所有患者均接受5 - HT3拮抗剂。纳入接受中度致吐性、多日、强化急性白血病化疗的成年患者。如果患者在研究期间接受的类固醇剂量大于生理剂量，则将其排除。主要终点是CINV的完全缓解（无呕吐或使用挽救性止吐药）。
本研究纳入58例患者，12例患者接受奥氮平治疗，46例患者为对照组。基线人口统计学特征相似。在研究人群中，89.7%患有急性髓系白血病，中位年龄为54岁（四分位间距42 - 63岁），34.5%为女性，27.6%既往有CINV。两组之间CINV的完全缓解情况相似，奥氮平组和对照组分别有4例（33.3%）和15例（32.6%）患者。两组之间的安全事件相似。
接受多日强化化疗的急性白血病患者发生CINV的风险很高。本研究中的有限数据表明，在节省类固醇的止吐方案中使用奥氮平耐受性良好，与对照组相比，CINV的发生率和严重程度相似。
