Komada 1999.

Methods	RCT Cross‐over
Participants	Participants with ALL receiving either high‐dose methotrexate (3 g/m²) or high‐dose cytarabine plus dexamethasone (3 g/m²). Participants aged 6.3 years (range 1 year to 14 years), 21/49 male
Interventions	Granisetron 20 mcg/kg given immediately prior to chemotherapy at 30 min IV infusion Granisetron 40 mcg/kg given immediately prior to chemotherapy at 30 min IV infusion
Outcomes	Episodes of vomiting recorded
Notes	13 participants receiving Ara‐C had their treatment 'contaminated' by the concurrent use of dexamethasone as an antiemetic
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not stated
Allocation concealment (selection bias)	Unclear risk	Not stated
Blinding (performance bias and detection bias) Acute nausea	High risk	Blinding of care provider: no Blinding of participant: no Blinding of outcome assessors: no
Blinding (performance bias and detection bias) Acute vomiting	High risk	Not reported
Blinding (performance bias and detection bias) Other outcomes	High risk	Not reported
Incomplete outcome data (attrition bias) All outcomes	Low risk	No dropouts in 24‐hour data, all completed cross‐over
Selective reporting (reporting bias)	Low risk	Unclear if the HD‐MTX and high‐dose Ara‐C were identified a priori
Other bias	High risk	Participants receiving Ara‐C had their treatment 'contaminated' by the concurrent use of dexamethasone