According to bone marrow transplant recipients, nausea and vomiting are two of the most debilitating side effects of the procedure, due to the high doses of chemotherapy and radiation administered. Now, researchers at Loyola University in Illinois have found a drug regimen that may greatly ease the bone marrow transplant experience.
"We now believe this should become a standard part of patients' care."—Dr. Patrick Stiff

Aprepitant (Emend®) was approved by the FDA in 2003 to help prevent and control vomiting and nausea from chemotherapy. The drug acts to block nausea/vomiting signals from the brain, as opposed to other anti-nausea/vomiting drugs that work by blocking signals from the stomach. Aprepitant is taken in conjunction with other anti-nausea drugs so that signals are blocked from both the brain and the stomach.

In bone marrow transplants, which are used to treat diseases such as leukemia, lymphoma, and Hodgkin's disease, patients receive high doses—higher than in other cancer treatments—of chemotherapy to kill cancer cells. Infusions of donated bone marrow cells are given to develop into healthy new immune cells, to replace the cells that are killed off by the chemotherapy treatments.

Dr. Patrick Stiff and a team of researchers from Loyola University Health System conducted a Phase III, blinded, prospective study with 179 participants undergoing bone marrow transplants. Seventy-three percent of patients receiving aprepitant in combination with a standard anti-nausea drug experienced no vomiting during the study period, compared with 23& of patients who received only a standard anti-nausea drug. Forty-nine percent of aprepitant patients experienced no vomiting and little or no nausea, compared with 15% of the placebo group.

Loyola has the largest bone marrow transplant program in Illinois. Dr. Stiff reported that they are aiming to make the procedure more patient-friendly, by alleviating the severe nausea and vomiting associated with the procedure. Without using aprepitant, transplant recipients report vomiting an average of 3 to 5 times per day, for up to a week. After reviewing the results of the study, Dr. Stiff and his team reported that "We now believe this should become a standard part of patients' care."