Toxicity assessment of concurrent gabapentin/pregabalin administration with high-dose melphalan in autologous hematopoietic cell transplant recipients
Year: 2021
Type: article
Study design: Observational Study
Abstract: Peripheral neuropathy is a common toxicity of various multiple myeloma regimens. A theoretical pharmacokinetic interaction mediated through L-amino acid transporter 1 and 2 exists between gabapentin (GP) and pregabalin (PG) with melphalan. Therefore, it is likely concurrent administration of either GP or PG will occur in patients receiving high-dose melphalan (HD-Mel) conditioning for autologous hematopoietic cell transplantation, which could potentially increase cellular uptake and worsen mucosal injury. A retrospective chart review of adult patients from January 2012 to July 2016 who received HD-Mel (140-200mg/m2) at West Virginia University Medicine was performed to assess toxicity and outcomes in these patients. A total of 80 patients were included in the study, with 30 patients receiving GP or PG and 50 control patients. There were no significant differences in grade 2 or higher mucositis, admissions for nausea/vomiting/diarrhea, intravenous opioid requirements, oral topical therapies, antidiarrheal medication use, rescue antiemetics, days of nausea or vomiting, pain scores, neutrophil or platelet engraftment, treatment-related mortality, progression-free survival, or overall survival. Our data suggest that it is safe to continue GP/PG therapy throughout HD-Mel therapy, with no negative transplant outcomes. Prospective studies or evaluation of larger databases are necessary to better characterize the clinical effect of concomitant therapy.
Source: Supportive Care in Cancer
Authors: Jonathan Angus, Aaron Cumpston, Lauren Veltri, Kelly G. Ross, Sijin Wen, Megan Dillaman
Institution: West Virginia University
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3164777364