ONDANSETRON VERSUS CHLORPROMAZINE FOR PREVENTING EMESIS IN BONE-MARROW TRANSPLANT RECIPIENTS - A DOUBLE-BLIND RANDOMIZED STUDY

Ondansetron, a selective 5-HT3 antagonist, is known to be effective fo r preventing emesis induced by cisplatin and other antineoplastic agen ts. We undertook a randomized double-blind study in a series of bone m arrow transplantation (BMT) recipients to assess the antiemetic effica cy and the safety of ondansetron in comparison with chlorpromazine, wh ich was being used at our institution, as the standard antiemetic agen t for the conditioning regimen. Forty patients submitted to BMT (21 au tologous, 19 allogeneic) were included in the study. Patients were ran domly assigned to receive ondansetron (as a loading dose of 8 mg iv on e hour before the beginning of the conditioning regimen followed by a continuous infusion of 1 mg per hour for the whole treatment period) o r chlorpromazine 60 mg/m2/day given by continuous infusion for the sam e period (maximum 8 days). Twenty patients were assigned to ondansetro n, while 20 were assigned to chlorpromazine. The response rate in term s of antiemetic efficacy and in nausea control was similar between the two treatment groups. On the contrary the two groups differed signifi cantly in regard to side-effects: patients receiving ondansetron exper ienced significantly less sedation (p=0.002), the absence of extrapyra midal reactions (p<0.001) and no need for dose reduction (p<0.001) as compared with patients treated with chlorpromazine.