Prophylactic defibrotide in allogeneic stem cell transplantation: minimal morbidity and zero mortality from veno-occlusive disease

Hepatic veno-occlusive disease after hematopoietic stem cell transplantation: update on defibrotide and other current investigational therapies

“…In a different series of 58 patients who received DF alone as VOD prophylaxis after allogeneic SCT, no cases of VOD meeting the Baltimore criteria were reported. 14 However, approximately half of the patients in this series actually received reduced intensity conditioning, and their risk for developing VOD was likely to be lower at baseline, although, like the prior study, comparison to historical control data in similar patient cohorts was shown to be highly favorable. Encouraging results with DF as VOD prophylaxis have also been reported in a case series of high VOD risk transplant recipients previously exposed to gemtuzumab ozogamicin, 71 and in children transplanted for infantile osteopetrosis.…”

“…[8][9][10][11] Recent studies have also demonstrated that DF is an effective agent for VOD prophylaxis after transplantation in patients at high risk for this complication. [12][13][14] …”

Defibrotide for Prevention and Treatment of Veno-Occlusive Disease in Adults: Single-Center Experience

“…The controlled trial of Chalandon et al suggested that defibrotide given in addition to heparin may be effective in VOD prophylaxis [18]. The study of Dignan F et al which included adult case series implies that prophylaxis with defibrotide may reduce the incidence of VOD following AHSCT [19]. In conclusion, there is limited information on the impact of defibrotide in the VOD prophylaxis in adults.…”

“…Since then, several studies in both adults and children have demonstrated encouraging responses with defibrotide in severe VOD [9][10][11][12][13]. Following the demonstration of the efficacy of defibrotide in the treatment of VOD, several studies investigated the role of this agent in prophylaxis [14][15][16][17][18][19]. In the review by Zhang L et al it was mentioned that most studies regarding prophylaxis involved pediatric patients and only one of them was a randomized controlled trial [20].…”

“…In the review by Zhang L et al it was mentioned that most studies regarding prophylaxis involved pediatric patients and only one of them was a randomized controlled trial [20]. To the best of our knowledge, only few studies have investigated the role of defibrotide for prophylaxis in adult patients following allogeneic hematopoietic stem cell transplantation (AHSCT) [18,19]. The controlled trial of Chalandon et al suggested that defibrotide given in addition to heparin may be effective in VOD prophylaxis [18].…”