Defibrotide for Prevention and Treatment of Veno-Occlusive Disease in Adults: Single-Center ExperienceYonal Ipek1*, KÄ±rkÄ±zlar Onur HakkÄ±2, Kalayoglu-Besisik Sevgi1 and Sargin Fatma Deniz1
- *Corresponding Author:
- Yonal Ipek
Istanbul Universitesi Istanbul Tip Fakultesi
Ic Hastaliklari ABD, Hematoloji BD, Fatih-Istanbul
E-mail: [email protected]
Received date: May 20, 2014; Accepted date: October 22, 2014; Published date: October 24,2014
Citation: Ipek Y, Hakki KO, Sevgi KB, Deniz SF (2014) Defibrotide for Prevention and Treatment of Veno-Occlusive Disease in Adults: Single-Center Experience. J Bone Marrow Res 2:148. doi:10.4172/2329-8820.1000148
Copyright: 2014 Ipek Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Hepatic veno-occlusive disease (VOD) has been reported at a rate up to 50% following intensive conditioning regimens used in allogeneic hematopoietic stem cell transplantation (AHSCT). Studies on the prophylactic effect of defibrotide to prevent hepatic VOD in adults are rare.
Purpose: The research presented here aimed to evaluate whether propylactic defibrotide use can reduce incidence and severity of VOD in adults undergoing AHSCT. Also, we aimed to assess the benefit of defibrotide for treatment of VOD.
Methods: Study population comprised 86 consecutive AHSCT patients transplanted between January 2005 and December 2009. 17 of the patients at high risk of developing VOD could have access to defibrotide and received defibrotide prophylaxis.
Results: Modified Seattle criteria were used for VOD diagnosis. 14 of 86 patients (10 severe, 3 moderate, 1 mild) were diagnosed with VOD (16.2%). VOD incidence was similar between patients transplanted before December 2004 and after January 2005 (9.3% and 16.2%, respectively; p =0.14, HR =1.88, 95% CI 0.82- 4.29). 13 of 14 patients diagnosed with VOD in the study population were treated with defibrotide whereas only 2 of 12 in the control group received defibrotide for treatment (92.8% and 16.6%, respectively; p =0.0002, HR =65 , 95% CI 5.13-823.1). Mortality rate of VOD in the controls was significantly higher than the study population (66.6% and 21.4%, respectively; p =0.044, HR =0.13, 95% CI 0.02-0.78).
Conclusions: Mortality rate related to VOD was lower in the defibrotide group. Therefore, we conclude defibrotide might be beneficial for treatment of VOD in adults.