Prophylactic defibrotide in allogeneic stem cell transplantation: minimal morbidity and zero mortality from veno-occlusive disease.
Veno-occlusive disease (VOD) is a common and high-risk complication of allogeneic stem cell transplantation (SCT). Defibrotide has recently been used successfully to treat the disorder. We report on 58 patients who received defibrotide prophylaxis without concurrent heparin. No patients fulfilled the Baltimore criteria for VOD or died of the condition within 100 days of SCT. None of this group developed haemorrhagic complications secondary to defibrotide. These observations suggest that prophylaxis with defibrotide alone may reduce the incidence of VOD post-SCT although a randomised controlled trial is warranted to further evaluate its role.
Dignan
F
F
Department of Haemato-oncology, Royal Marsden Hospital, Downs Road, Surrey, UK. fionadignan@hotmail.com
Gujral
D
D
Ethell
M
M
Evans
S
S
Treleaven
J
J
Morgan
G
G
Potter
M
M
D000293:Adolescent; D000328:Adult; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006504:Hepatic Veno-Occlusive Disease / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008223:Lymphoma / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011089:Polydeoxyribonucleotides / Q000627:therapeutic use*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D016019:Survival Analysis; D014184:Transplantation, Homologous
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000970:Antineoplastic Agents; D010975:Platelet Aggregation Inhibitors; D011089:Polydeoxyribonucleotides; D000074323:Alemtuzumab; C036901:defibrotide