Granisetron (Kytril) plus dexamethasone for antiemetic control in bone marrow transplant patients receiving highly emetogenic chemotherapy with or without total body irradiation

This prospective trial evaluated the efficacy and toxicity of granisetron f or antiemetic control in patients receiving high-dose cyclophosphamide (CY) -containing regimens with/without TBI for bone marrow (BM) or peripheral bl ood stem cell (PBSC) transplantation or PBSC mobilization. Granisetron 1 mg i.v. plus dexamethasone 10 mg i.v. were administered daily 30 min before c hemotherapy or radiation for a median of 5 days. Response was defined as th e number of emetic episodes per 24 h: complete response, 0 and no emetic re scue; major response, 1-2; minor response, 3-5; failure, >5. One hundred pa tients were enrolled. Ninety-eight received CY-containing regimens and 26 o f these additionally received TBI (12 Gy divided over 4 days). Response was complete on 216 (47%) of a total 456 patient days, major on 222 (49%), min or on 14 (3%), and failure on 4 (1%). Mean number of emetic episodes per pa tient per day and breakthrough medication required per patient per day was 0.24 (range 0-8) and 0.40 (range 0-8), respectively. Adverse effects were m inimal, with headache (20%) reported most frequently. Based on these result s, granisetron plus dexamethasone is an effective and well-tolerated antiem etic regimen in BMT/PBSCT recipients conditioned with high-dose chemotherap y with/without TBI.