• nausea/vomiting as defined below
  
• Emetic control will be defined by the number of emetic episodes (see definitions) occurring within a 24-hour period, or the requirement for rescue medication. Emetic control will be defined as follows:
  
• Complete: no episodes of emesis or nausea in any 24-hour period after administration of study antiemetics, with no rescue antiemetics needed.
  
• Major: One or two episodes of nausea or vomiting, or the need for antiemetic rescue medication.
  
• Minor: Three to five episodes of nausea or vomiting.
  
• Treatment failure: More than five emetic episodes
  
• Emetic episodes will be defined as single vomit or retch, or any number of continuous vomits or retches; distinct episodes must be separated by at least one minute.
  
• Nausea61: A subjective, unobservable phenomenon of an unpleasant sensation in the back of the throat and the epigastrium that may or may not culminate in vomiting.
  
• Vomiting61: The forceful expulsion of the contents of the stomach, duodenum or jejunum through the oral cavity.
  
• Retching61: The unsuccessful attempt to vomit without expelling gastrointestinal contents.
  
• Acute phase62: The first 24 hours after initiation of chemotherapy.
  
• Delayed phase62: Nausea and vomiting occurring 24 hours after initiation of chemotherapy administration. It may begin as early as 16 hours after chemotherapy administration.
  
• Anticipatory CINV62: Nausea and vomiting occurring as a result of a conditioned response from previous chemotherapy treatment.
  
• Breakthrough CINV62: Nausea and vomiting occurring despite preventive therapy.
  
• Refractory CINV62: Nausea and vomiting occurring during subsequent cycles of chemotherapy when antiemetic prophylaxis or rescue therapy (or both) has failed in earlier cycles
  
• Objective Measurements
  
• 7.3.1.1 Proportion of patients with or without emesis in the acute and delayed phase
  
• 7.3.1.2. Number, time to onset, and duration of emetic episodes after chemotherapy administration
  
• 7.3.1.3 Need for breakthrough antiemetics
  

• pharmacokinetic parameters as well as Patient Treatment Diary
  
• • Daily while hospitalized, beginning on day 1 of transplant conditioning regimen until count recovery (ANC > 1500 x 2 days) and then weekly until day +30.
  
• • Once discharged, weekly until day + 30 post transplant
  
• • Nausea will be assessed every 24 hours in the patient diary using a 100-mm horizontal visual analog scale
  
• • Patient's number of emetic episodes will be documented
  
• • Record of oral fluid intake
  
• • Quality of life questions pertaining to nausea and vomiting will be assessed
  
• 7.3.3 Toxicity Assessment (see Appendix C)
  
• 7.3.3.1 Toxicity of the antiemetic regimens will be assessed every 24 hours until count recovery (ANC >1500 x 2 days) and then weekly until day +30.
  
• 7.3.3.1.1 Side effects associated with the antiemetics
  
• 7.3.3.1.2 Creatinine daily until count recovery (ANC >1500 x 2 days) and then weekly until day +30
  
• 7.3.3.1.3 Liver function tests including total bilirubin, AST, ALT, and alkaline phosphatase at least twice weekly until count recovery (ANC >1500 x 2 days) and then weekly until day +30
  

Inclusion Criteria:

• Male or female patients 18 years of age or older
• Patients deemed eligible to undergo autologous bone marrow or peripheral stem cell transplant therapy per usual transplant inclusion and exclusion criteria
• Patients with Non-Hodgkins Lymphoma or Multiple Myeloma
• Written informed consent

Exclusion Criteria:

• Nausea at baseline
• Chronic use of other antiemetic agent(s)
• Gastrointestinal obstruction or active peptic ulcer
• Radiation therapy to pelvis or abdomen within 1 week before or after study day 1
• Allogeneic stem cell transplant recipient
• AST > 3x ULN
• ALT > 3x ULN
• Bili > 3x ULN
• Alk Phos > 3x ULN
• Creatinine >2
• Known hypersensitivity to any component of study regimen
• Pregnant or lactating women
• Participating in a clinical trial which involves other investigational agent(s)
• Patients taking any of the following medications: warfarin, oral contraceptives (except for the administration of stopping menses), tolbutamide, phenytoin, midazolam, ketoconazole, rifampin, paroxetine, and/or diltiazem.