Congress Abstracts 2006

214

THERAPEUTIC ADMINISTRATION OF ORANGE TO RELIEVE DMSO-RELATED SYMPTOMS DURING AUTOLOGOUS PERIPHERAL BLOOD STEM CELL REINFUSIONS. Seth Eisenberg, RN, ADN, OCN^®, Seattle Cancer Care Alliance, Seattle, WA; and Pamela Potter, ARNP, DNSc, University of Washington, Seattle, WA.

DMSO is commonly used as a preservative for autologous hematopoietic stem cells. During reinfusion, patients frequently experience throat discomfort, coughing and nausea or vomiting. Anecdotal experience suggests that using an orange to smell or taste during the reinfusion may alleviate symptoms in some patients. Literature reviews failed to produce any studies on the potential efficacy of orange for this application.

While limited in duration, symptoms associated with autologous reinfusions can cause significant patient distress. Coughing and choking increases anxiety that is often be heightened during this time-point in the transplant continuum. No specific medical interventions have reported efficacy for these symptoms, despite the administration of antiemetics and other premedications.

In the same way that menthol cough drops stimulate the oral-nasal receptors to reduce symptoms of sinus congestion, it is postulated that orange or orange vapors might have a similar effect on the throat and oral-nasal cavity. Anecdotal reports suggest orange aroma may compete with the pungent odor of DMSO as it is exhaled, although this mechanism of action has not been proven.

This is a pilot study of 60 patients receiving an autologous reinfusion in the SCCA Ambulatory clinic. Participants are randomized to one of three arms: Orange Intervention (OI), Orange Aromatherapy (OAI), or control (deep breathing). Control groups who receive more than three bags of cells are then crossed over to receive either the OI or OAI. All subjects are monitored for up to six bags of cells. At the completion of each bag, patients are asked to rate their degree (0-10) of throat "tickling" or discomfort, nausea, retching and urge to cough. All responses are documented using a laptop computer.

This pilot study is currently in progress, with 25 of 60 patients accrued thus far. At completion, data will be analyzed to determine if either intervention is beneficial for reducing DMSO-related symptoms, and if one intervention is superior. This will be the first study with empiric evidence to support or disprove the use of oranges for ameliorating a significant discomfort associated with autologous reinfusions. These results may provide the foundation for further research in this area.

Funding Sources: Puget Sound Oncology Nursing Society