Music as an adjunct to antiemetic therapy.

PURPOSE/OBJECTIVES: To test whether use of music as a diversional intervention during high-dose chemotherapy administration would affect perception of nausea and episodes of vomiting. SAMPLE: 39 patients undergoing bone marrow transplant. A total of 33 patients were included in the data analysis, with 17 in the control group and 16 in the music intervention group. METHODS: Patients were assigned randomly to a control group (usual antiemetic protocol) or the experimental group (usual antiemetic group plus music intervention during the 48 hours of high-dose cyclophosphamide administered as part of the preparative regimen). MAIN RESEARCH VARIABLES: Use of a music intervention, perception of nausea, and instances of vomiting. FINDINGS: Significant differences were found between group scores on a visual analog scale for nausea and number of episodes of vomiting, demonstrating that the experimental group experienced less nausea and fewer instances of vomiting. CONCLUSION: This study found that music is an effective adjunct to a pharmacologic antiemetic regimen for lessening nausea and vomiting, and this study merits further investigation through a larger multi-institutional effort. IMPLICATIONS FOR NURSING PRACTICE: Using music as a diversional adjunct intervention to antiemetic therapy is helpful in decreasing nausea and vomiting. The intervention can be initiated independently by nurses and individualized for each patient, leading to greater patient comfort and compliance with high-dose chemotherapy.

Mobilization of peripheral blood stem cells in children using G-CSF after carboplatin containing myelosuppressive chemotherapy.

PURPOSE: Peripheral blood stem cell (PBSC) apheresis provides an alternative to autologous marrow harvest as a source of hematologic stem cells for transplantation in children with solid tumors. PATIENTS AND METHODS: Eight children with metastatic or recurrent solid tumors underwent 27 apheresis procedures. Recovery from myelosuppressive chemotherapy occurred without continuous daily growth factor support prior to mobilization. Granulocyte colony stimulating factor (G-CSF) at 16 microgs/kg/day was used to increase stem cells in the peripheral circulation. CD 34 positive cells, mononuclear cells (MNC), and CFU-GM were measured in the apheresis products. Prior chemotherapy was examined as a clinical factor that affected PBSC yield. RESULTS: A significant correlation was found between CD 34+/kg and CFU-GM/kg of the products (r = 0.758, P < 0.001). Patients receiving cumulative doses of carboplatin over 1,600 mg/m2 produced adequate MNC (1 x 10(8)/kg) but yielded significantly less CD 34+ cells or CFU-GM than those patients receiving less carboplatin. Prior doses of etoposide and ifosfamide did not effect PBSC yield. CONCLUSIONS: The mobilization technique was well tolerated, and the products obtained produced trilineage engraftment in the patients that underwent peripheral blood stem cell transplantation. Peripheral blood stem cell apheresis in children can be optimized by selection of appropriate candidates and mobilization with G-CSF after an absence of hematopoietic growth factor support.