Is Defibrotide Prophylaxis Effective on Graft Versus Host Disease in Patients with Allogeneic Stem Cell Transplantation?

Introduction: Sinusoidal obstruction syndrome (SOS) is one of the complications of allogeneic stem cell transplantation (allo-SCT). Defibrotide (DF) is used effectively in SOS prophylaxis and treatment. Graft versus host disease (GVHD) is a significant cause of morbidity and mortality in allo-SCT. Here, we retrospectively investigated the effect of DF on the development of GVHD in these patients.

Methods: We evaluated 81 allo-transplanted patients due to various diagnoses (benign or malignant), retrospectively. Thirty-four patients used DF as prophylaxis while 47 patients did not receive it. Acute and chronic GVHD assessments were performed at +30/100th day and throughout the life of the patients, respectively.

Results: Acute GVHD was more common with DF use (82% vs 61%). There was no statistical significance in terms of the effect on chronic GVHD. We observed that one patient in the non- DF group developed SOS.

Conclusions: DF may be beneficial to prevent acute GVHD. However, we observed that GVHD and mortality were more common in patients using DF. This is probably due to the similarity of high-risk criteria between GVHD and SOS. We have not found a significant association between defibrotide use and the development of chronic GVHD.