Nausea and vomiting in children and adolescents receiving intrathecal methotrexate: A prospective, observational study.

Flank, Jacqueline; Nadeem, Komail; Moledina, Sheliza; Khanna, Mila; Schindera, Christina; Punnett, Angela; Dupuis, L Lee (2017). Nausea and vomiting in children and adolescents receiving intrathecal methotrexate: A prospective, observational study. Pediatric blood & cancer, 64(10), e26603. Wiley-Liss 10.1002/pbc.26603

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BACKGROUND The prevalence of nausea and vomiting after receipt of intrathecal methotrexate (IT-MTX) in pediatric oncology patients is unknown. METHODS Patients (4-18 years) about to receive IT-MTX were eligible to participate in this prospective, observational study. Patients received antiemetics as prescribed by their clinical team. Nausea severity (patient-assessed), timing of emetic episodes, and administration of antiemetics were recorded beginning immediately prior to IT-MTX administration, for the next 24 hr (acute phase), and for a maximum of 7 additional days (delayed phase). Complete chemotherapy-induced nausea and vomiting (CINV) control was defined as no emetic episodes and no nausea. RESULTS One hundred patients consented to participate in this study; 70 provided evaluable data (mean age: 8.3 years; range: 4.1-17.6). Most (94%) received propofol-containing anesthesia for IT-MTX administration. Most (89%) received a 5-HT3 antagonist prior to IT-MTX. During the acute phase, 36 children (51%) experienced complete CINV control, 67 (96%) complete vomiting control, and 36 (51%) complete nausea control. Severe acute phase nausea was reported by 12 children (17%). During the delayed phase, 35 patients (50%) experienced complete CINV control, 60 (86%) complete vomiting control, and 36 (51%) complete nausea control. Severe nausea was reported in the delayed phase by 27 (39%) patients. CONCLUSIONS Most pediatric patients who received IT-MTX and prophylaxis with ondansetron or granisetron experienced complete acute and delayed vomiting control. However, nausea control was poor and severe nausea was reported by many children. Effective interventions to control nausea are needed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Schindera, Christina

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1545-5009

Publisher:

Wiley-Liss

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

04 Jan 2018 13:54

Last Modified:

15 Jan 2020 05:06

Publisher DOI:

10.1002/pbc.26603

PubMed ID:

28500750

Uncontrolled Keywords:

chemotherapy injections: spinal methotrexate nausea pediatrics vomiting

BORIS DOI:

10.7892/boris.106756

URI:

https://boris.unibe.ch/id/eprint/106756

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