Impact of defibrotide in the prevention of acute graft-versus-host disease following allogeneic hematopoietic cell transplantation - Université de Lille Accéder directement au contenu
Article Dans Une Revue The Annals of pharmacotherapy Année : 2022

Impact of defibrotide in the prevention of acute graft-versus-host disease following allogeneic hematopoietic cell transplantation

Résumé

BACKGROUND: Defibrotide is indicated for patients who develop severe sinusoidal obstructive syndrome following allogeneic hematopoietic cell transplantation (allo-HCT). Preclinical data suggested that defibrotide carries a prophylactic effect against acute graft-versus-host disease (aGVHD). OBJECTIVE: The purpose of this study was to investigate the effect of defibrotide on the incidence and severity of aGVHD. METHODS: This single-center retrospective study included all consecutive transplanted patients between January 2014 and December 2018. A propensity score based on 10 predefined confounders was used to estimate the effect of defibrotide on aGVHD via inverse probability of treatment weighting (IPTW). RESULTS: Of the 482 included patients, 64 received defibrotide (defibrotide group) and 418 did not (control group). Regarding main patient characteristics and transplantation modalities, the two groups were comparable, except for a predominance of men in the defibrotide group. The median age was 55 years (interquartile range [IQR]: 40-62). Patients received allo-HCT from HLA-matched related donor (28.6%), HLA-matched unrelated donor (50.8%), haplo-identical donor (13.4%), or mismatched unrelated donor (7.0%). Stem cell source was either bone marrow (49.6%) or peripheral blood (50.4%). After using IPTW, exposure to defibrotide was not significantly associated with occurrence of aGVHD (HR = 0.97; 95% CI 0.62-1.52; P = .9) or occurrence of severe aGVHD (HR = 1.89, 95% CI: 0.98-3.66; P = .058). CONCLUSION AND RELEVANCE: Defibrotide does not seem to have a protective effect on aGVHD in patients undergoing allo-HCT. Based on what has been reported to date and on these results, defibrotide should not be considered for the prevention of aGVHD outside clinical trials.
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Dates et versions

hal-04307362 , version 1 (26-11-2023)

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Remi Tilmont, Ibrahim Yakoub-Agha, Nassima Ramdane, Micha Srour, Valerie Coiteux, et al.. Impact of defibrotide in the prevention of acute graft-versus-host disease following allogeneic hematopoietic cell transplantation. The Annals of pharmacotherapy, 2022, The Annals of pharmacotherapy, 56 (9), p. 1007 - 1015. ⟨10.1177/10600280211068177⟩. ⟨hal-04307362⟩

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