Abstract 2725
Background
The oral, fixed-combination NEPA containing netupitant and palonosetron target crucial pathways involved in both acute and delayed chemotherapy-induced nausea and vomiting (CINV) in patients with highly emetogenic chemotherapy.Hematopoietic stem cell transplantation (HSCT) is associated with infectious complications, especially bloodstream infections (BSI). The risk factors associated with BSI include presence of indwelling vascular catheters. NEPA eliminates accessing intravenous catheters leading to a decreased risk of infection in HSCT recipients.There is a paucity of studies about the management of CINV during preparative regimens for HSCT. The aim of this study was to assess the safety of NEPA during and after HSCT conditioning.
Methods
Patients with chronic myeloid leukemia, multiple myeloma, myelodysplastic syndrome, and acute myeloid leukemia who received an allogeneic HSCT between 2017 and 2018 were retrospective studied. Conditioning regimen consisted of fludarabine and busulfan. Graft versus host disease prophylaxis was done with high-dose cyclophosphamide on days +3 to + 4 post-HSCT. Patients received a single capsule of NEPA prior to conditioning regimen and before cyclophosphamide, both with oral dexamethasone on days 1-3 . Safety was assessed by evaluation of adverse events and use of rescue medications (baclofen for hiccups and lactitol, macrogol and sennosides for constipation).
Results
Six patients were included: 4/6were male and median age was 50 years (IQR: 46-53 years). Two patients reported hiccups needing baclofen and 6 required rescue medications for constipation. Five out of six patients presented neutropenic enterocolitis on day +7, oral intake was stopped in 4 of them, total parenteral nutrition was started in 3 cases, 3 patients required extra antibiotic coverage, and 4 received analgesic therapy. All patients improved with conservative measures.
Conclusions
In this real-world observational study, the incidence of neutropenic enterocolitis was considerably higher than previous reports in HSCT recipients. It may be associated with NEPA administration but future studies will be needed to confirm this relationship.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Hospital Clínic Barcelona.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4822 - Efficiacy of different nutritional intervention on nutritional status and quality of life for local advanced nasopharyngeal carcinoma patients: a prospective clinical trial
Presenter: Yuan-yuan Chen
Session: Poster Display session 3
Resources:
Abstract
2628 - Apatinib in treating patients with platinum-resistant or platinum-refractory recurrent or metastatic nasopharyngeal carcinoma
Presenter: Changjuan Tao
Session: Poster Display session 3
Resources:
Abstract
4887 - Impact of tumor site and adjuvant radiotherapy on survival of adenoid cystic carcinoma: a SEER database analysis
Presenter: Jason Tasoulas
Session: Poster Display session 3
Resources:
Abstract
2634 - Efficacy and safety of anlotinib for patients with recurrent and/or metastatic salivary gland carcinomas
Presenter: Wen Jiang
Session: Poster Display session 3
Resources:
Abstract
3568 - ACCURACY a phase (P) 2 trial of AL101, a pan-Notch inhibitor, in recurrent/metastatic (R/M) adenoid cystic carcinoma (ACC) patients (pts) with Notch activating mutations (Notch act mut): preliminary safety and efficacy data.
Presenter: Renata Ferrarotto
Session: Poster Display session 3
Resources:
Abstract
683 - Pathologic Staging Changes in Oral Cavity Squamous Cell Carcinoma—Stage Migration and Implications for Adjuvant Treatment
Presenter: Zain Husain
Session: Poster Display session 3
Resources:
Abstract
563 - Expression of immune response biomarkers in head and neck squamous cell carcinoma (HNSCC) in irradiated area
Presenter: Carole Pflumio
Session: Poster Display session 3
Resources:
Abstract
4030 - HLA-Ligandome analysis reveals target antigens of oropharyngeal squamous cell carcinoma
Presenter: Simon Laban
Session: Poster Display session 3
Resources:
Abstract
2979 - Topographical distribution of sentinel lymph nodes in early tongue squamous cell carcinomas
Presenter: Hiroyuki Goda
Session: Poster Display session 3
Resources:
Abstract
3517 - Role of follow-up (FU) FDG-PET/CT (FU-FDG-PET/CT) in patients with locoregionally advanced squamous cell carcinoma of the head and neck (LA-HNSCC) treated with chemotherapy and radiotherapy (RT), either concurrent (CRT) or sequential (ST).
Presenter: Bert Van Den Heuvel
Session: Poster Display session 3
Resources:
Abstract