Chemotherapy-induced nausea and vomiting from oral chemotherapy for childhood acute lymphoblastic leukaemia: feasibility study

BMJ Support Palliat Care. 2022 Nov;12(e5):e646-e649. doi: 10.1136/bmjspcare-2019-002022. Epub 2019 Nov 29.

Abstract

Objective: To evaluate the feasibility of a large prospective trial aimed at improving chemotherapy-induced nausea and vomiting (CINV) control in paediatric patients undergoing oral chemotherapy during acute lymphoblastic leukaemia (ALL) maintenance therapy.

Methods: English-speaking children, 4.0-17.99 years old and undergoing ALL maintenance treatment with an English-speaking guardian, were eligible to participate in this observational, serial, cross-sectional feasibility study. Data were collected from participants over one to three 7-day periods during months 2-3, 5-6 and 11-12 of ALL maintenance treatment. A future trial was considered feasible if the mean time to enrol 10 patients in each of three data collection periods was ≤1 year with ≥80% of patients returning evaluable data. CINV control was described as a secondary endpoint.

Results: Twenty-nine of 31 consenting patients (median age: 6.5 years, IQR: 5.1-9.2) completed the study: 10 in months 2-3, 10 in months 5-6 and 9 in months 11-12. The total time to recruit 29 patients was 1.2 years. In each of the three data collections periods, 72% of the patients provided evaluable data. Complete CINV control was reported in 6/21 (29%) evaluable study periods.

Conclusions: A future trial to evaluate interventions to improve CINV control in patients with ALL undergoing oral maintenance chemotherapy as designed in this study is not feasible. An electronic data capture method and deferring patient recruitment until the mid-maintenance to late-maintenance phase should be considered in the design of a future trial.

Keywords: leukaemia; nausea and vomiting; paediatrics.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Antiemetics* / therapeutic use
  • Antineoplastic Agents* / adverse effects
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Feasibility Studies
  • Humans
  • Nausea / chemically induced
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy
  • Prospective Studies
  • Vomiting / chemically induced
  • Vomiting / drug therapy

Substances

  • Antiemetics
  • Antineoplastic Agents