RANDOMIZED COMPARISON OF ONDANSETRON AND METOCLOPRAMIDE PLUS DEXAMETHASONE FOR CHEMOTHERAPY-INDUCED EMESIS

The serotonin (5HT(3)) antagonist ondansetron was compared in a random ised study with metoclopramide and for the prevention of induced emesi s. Thirty children aged 1-15 years with acute lymphoblastic leukaemia received 'intensification modules' according to the MRC United Kingdom acute lymphoblastic leukaemia regimen UKALL XI. This contains the mod erately emetogenic drugs daunorubicin, etoposide, and cytarabine. Fift een children received an intravenous loading dose of ondansetron follo wed by intravenous or oral doses 12 hourly for five days. Fifteen chil dren received intravenous metoclopramide every six hours for three day s with a loading dose of dexamethasone, repeated every eight hours for three days intravenously or orally. Efficacy was assessed by a diary card documenting the incidence of nausea, retching, or vomiting. In th e 24 hour period after starting chemotherapy, ondansetron was more eff ective, with a complete or major response rate of 93%, compared with 3 3% using metoclopramide/dexamethasone.