Page last updated: 2024-10-15

defibrotide

Description

defibrotide: Single-stranded polydeoxyribonucleotide extracted from mammalian organs and used in the treatment of HEPATIC VENO-OCCLUSIVE DISEASE in patients with kidney or lung abnormalities following HEMATOPOIETIC STEM CELL TRANSPLANTATION [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

Cross-References

ID SourceID
PubMed CID135565962
CHEMBL ID3674153
SCHEMBL ID419884
MeSH IDM0112022

Synonyms (18)

Synonym
83712-60-1
defibrotide
defibrotide sodium
sta-1474
SCHEMBL419884
1118915-78-8
5-hydroxy-2-isopropyl-4-(4-(1-methyl-1h-indol-5-yl)-5-oxo-4,5-dihydro-1h-1,2,4-triazol-3-yl)phenyl dihydrogen phosphate
3h-1,2,4-triazol-3-one, 2,4-dihydro-5-(2-hydroxy-5-(1-methylethyl)-4-(phosphonooxy)phenyl)-4-(1-methyl-1h-indol-5-yl)-
e1942e7k32 ,
unii-e1942e7k32
JNWFIPVDEINBAI-UHFFFAOYSA-N
CHEMBL3674153
us9120745, 3
bdbm176684
BCP24376
[5-hydroxy-4-[4-(1-methylindol-5-yl)-5-oxo-1h-1,2,4-triazol-3-yl]-2-propan-2-ylphenyl] dihydrogen phosphate
Q27276739
BCP23704

Research Excerpts

Overview

Defibrotide is a polyanionic compound with fibrinolytic, antithrombotic, and antiinflammatory properties. It has been approved for the treatment of veno-occlusive disease/sinusoidal obstruction syndrome after allogeneic hematopoietic cell transplantation.

ExcerptReference
"Defibrotide is an anti-inflammatory and antithrombotic agent that may protect the endothelium during conditioning."( A pilot trial of prophylactic defibrotide to prevent serious thrombotic microangiopathy in high-risk pediatric patients.
Chu, J; Dara, J; Dvorak, CC; Hermiston, ML; Higham, CS; Huang, JN; Kharbanda, S; Melton, A; Shimano, KA; Winestone, LE, 2022
)
"Defibrotide is a polyanionic compound with fibrinolytic, antithrombotic, and antiinflammatory properties."( Defibrotide Therapy for SARS-CoV-2 ARDS.
Braun, TM; Frame, D; Gregg, KS; Holinstat, M; Hyzy, RC; Kaul, DR; Lama, VN; Lawrence, DA; Maliarik, M; Pipe, SW; Richardson, PG; Scappaticci, GB; Sisson, TH; Yanik, GA, 2022
)
"Defibrotide (DF) is a drug with an endothelium-protective effect that has been approved for the treatment of veno-occlusive disease/sinusoidal obstruction syndrome after allogeneic hematopoietic cell transplantation."( Acute Graft-vs.-Host Disease-Associated Endothelial Activation
Carreras, E; Cordes, S; Diaz-Ricart, M; Escolar, G; Hamelmann, H; Kalupa, M; Martinez-Sanchez, J; Mertlitz, S; Mir, E; Moreno-Castaño, AB; Palomo, M; Penack, O; Riesner, K; Rovira, M; Torramade, S, 2019
)
"Defibrotide is a multi-target drug successfully employed for prophylaxis and treatment of veno-occlusive disease/sinusoidal obstruction syndrome."( Defibrotide inhibits donor leucocyte-endothelial interactions and protects against acute graft-versus-host disease.
Blanquer, M; Carreras, E; Díaz-Ricart, M; García-Bernal, D; García-Guillén, AI; Martínez, CM; Millán-Rivero, JE; Moraleda, JM; Palomo, M; Sackstein, R, 2020
)
"Defibrotide is an anti-ischemic and antithrombotic drug with no systemic anticoagulant effects."( Successful defibrotide treatment of a patient with veno-occlusive disease after living-donor liver transplantation: A case report.
Choi, BH; Ko, HJ; Lee, JH; Lee, TB; Ryu, JH; Shim, JR; Yang, K, 2021
)
"Defibrotide (DF) is a polyribonucleotide with antithrombotic, pro-fibrinolytic, and anti-inflammatory effects on endothelium. "( Defibrotide: potential for treating endothelial dysfunction related to viral and post-infectious syndromes.
Baron, RM; Calabretta, E; Carlo-Stella, C; Díaz-Ricart, M; Fareed, J; García-Bernal, D; Iacobelli, M; Jara, R; Moraleda, JM; Palomo, M; Richardson, E; Richardson, PG; Vlodavsky, I; Yanik, G, 2021
)
"Defibrotide is an agent used to treat sinusoidal obstruction syndrome (SOS/VOD) in patients undergoing haemopoietic stem cell transplantation. "( Defibrotide for the treatment of sinusoidal obstruction syndrome: evaluation of response to therapy and patient outcomes.
Avery, S; Coutsouvelis, J; Dooley, M; Kirkpatrick, C; Spencer, A, 2018
)
"Defibrotide appears to be a safe prophylaxis for SOS. "( Safety and effects of prophylactic defibrotide for sinusoidal obstruction syndrome in hematopoietic stem cell transplantation.
Eom, HS; Ghim, TT; Kong, SY; Kwon, YJ; Lee, HW; Lim, YJ; Park, BK; Park, HJ; Park, JA; Park, M; Yoon, JH; Yun, T, 2013
)
"Defibrotide is a polydisperse mixture of single-stranded oligonucleotides with many pharmacologic properties and multiple actions on the vascular endothelium. "( An Analysis of Responses to Defibrotide in the Pulmonary Vascular Bed of the Cat.
Harris, ZI; Kaye, AD; Kaye, AJ; Luk, EJ; Skonieczny, BD,
)
"Defibrotide is a polynucleotide with profibrinolytic, anti-ischemic, and anti-inflammatory activity."( The Role of Thromboelastography in Pediatric Patients with Sinusoidal Obstructive Syndrome Receiving Defibrotide.
Adams, RH; Gendreau, JL; Knoll, C; Su, LL, 2017
)
"Defibrotide is a complex mixture of single-stranded polydeoxyribonucleotides that is approved in the United States for treating hepatic VOD/SOS with renal or pulmonary dysfunction post-HSCT and in the European Union, Israel, and South Korea for treating severe hepatic VOD/SOS post-HSCT."( Defibrotide for Patients with Hepatic Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome: Interim Results from a Treatment IND Study.
Antin, JH; Grupp, SA; Hannah, AL; Hume, R; Iacobelli, M; Kernan, NA; Lehmann, L; Miloslavsky, M; Nejadnik, B; Richardson, PG; Shore, T; Smith, AR; Soiffer, RJ; Triplett, BM, 2017
)
"Defibrotide is a deoxyribonucleic acid derivative that has been developed for the treatment of different vascular disorders."( Defibrotide: a review on clinical use and future development.
Boccadoro, M; Cavallo, F; Larocca, A; Magarotto, V; Palumbo, A; Patriarca, F; Rossi, D, 2008
)
"Defibrotide (DF) is a mixture of porcine-derived single-stranded phosphodiester oligonucleotides (9-80-mer; average, 50-mer) that has been successfully used to treat severe hepatic veno-occlusive disease (sVOD) with multiorgan failure (MOF) in patients who have received cytotoxic chemotherapy in preparation for bone marrow transplantation. "( Angiogenesis alteration by defibrotide: implications for its mechanism of action in severe hepatic veno-occlusive disease.
Ayyanar, K; Benimetskaya, L; Echart, C; Iacobelli, M; Richardson, P; Shin, J; Stein, CA; Voskresenskiy, AM; Wu, S; Zhou, JF, 2008
)
"Defibrotide seems to be a promising treatment for SOS, and the initiation of a clinical study in Japan would be important."( [Defibrotide therapy for patients with sinusoidal obstruction syndrome after hematopoietic stem cell transplantation].
Funakoshi, Y; Katayama, Y; Kawamori, Y; Kawano, H; Kawano, Y; Matsui, T; Minagawa, K; Nishikawa, S; Okamura, A; Ono, K; Sada, A; Shimoyama, M; Yakushijin, K; Yamamoto, K, 2009
)
"Defibrotide is a polydisperse oligonucleotide with antithrombotic, profibrinolytic, anti-ischemic, and antiadhesive properties."( The fibrinolytic mechanism of defibrotide: effect of defibrotide on plasmin activity.
Echart, CL; Fareed, J; Ferro, LI; Graziadio, B; Iacobelli, M; Richardson, PG; Somaini, S, 2009
)
"Defibrotide is a novel orally bioavailable polydisperse oligonucleotide with anti-thrombotic and anti-adhesive effects. "( Melphalan, prednisone, thalidomide and defibrotide in relapsed/refractory multiple myeloma: results of a multicenter phase I/II trial.
Anderson, K; Benevolo, G; Boccadoro, M; Bringhen, S; Cavallo, F; Gaidano, G; Gay, F; Genuardi, M; Iacobelli, M; Kotwica, K; Larocca, A; Magarotto, V; Masini, L; Mitsiades, C; Palumbo, A; Richardson, P; Rossi, D; Rus, C, 2010
)
"Defibrotide (DF) is a novel agent with both antithrombotic and fibrinolytic properties that has emerged as an effective therapy for severe VOD."( Use of defibrotide in the treatment and prevention of veno-occlusive disease.
Ho, V; Linden, E; Revta, C; Richardson, P, 2009
)
"Defibrotide is a polydisperse oligonucleotide obtained from porcine intestinal mucosa and prepared by controlled depolymerization of DNA. "( Update on the use of defibrotide.
Bringhen, S; Guglielmelli, T; Palumbo, A, 2012
)
"Defibrotide is a single-stranded nucleic acid polymer originally derived from porcine mucosa. "( Oligodeoxyribonucleotides derived from salmon sperm DNA: an alternative to defibrotide.
Guo, Y; Hui, CY; Shao, JH; Yang, XQ; Zhang, W; Zhang, X, 2013
)
"Defibrotide is a polydeoxyribonucleotide, which significantly reduces the expression of adhesion molecules on endothelial cells. "( Defibrotide in combination with granulocyte colony-stimulating factor significantly enhances the mobilization of primitive and committed peripheral blood progenitor cells in mice.
Carlo-Stella, C; Cleris, L; Di Nicola, M; Formelli, F; Gianni, MA; Longoni, P; Magni, M; Milanesi, M; Stucchi, C, 2002
)
"Defibrotide (DF) is a polydeoxyribonucleotide, which has been found to have anti-thrombotic, anti-ischaemic and thrombolytic properties without causing significant anti-coagulation."( Role of plasminogen activator inhibitor-1 (PAI-1) levels in the diagnosis of BMT-associated hepatic veno-occlusive disease and monitoring of subsequent therapy with defibrotide (DF).
Bowyer, K; Chang, J; Chopra, R; Eaton, JD; Kaleelrahman, M; Leeming, D; Scarffe, JH; Taberner, D, 2003
)
"Defibrotide (DF) is a polydeoxyribonucleotide with aptameric activity on endothelium."( Defibrotide in the treatment of children with veno-occlusive disease (VOD): a retrospective multicentre study demonstrates therapeutic efficacy upon early intervention.
Basu, O; Corbacioglu, S; Dilloo, D; Greil, J; Gross-Wieltsch, U; Gruhn, B; Güngör, T; Laws, HJ; Mihatsch, W; Peters, C; Ridolfi-Lüthy, A; Schulz, AS; Straham, B; Strahm, B; Sykora, KW; Wulffraat, N, 2004
)
"Defibrotide is a single-stranded polydeoxyribonucleotide with anti-thrombotic, anti-ischemic, anti-inflammatory and thrombolytic properties, but without systemic anticoagulant effects, and some encouraging results have been reported in western countries."( Successful treatment with defibrotide for sinusoidal obstruction syndrome after hematopoietic stem cell transplantation.
Chihara, K; Ito, M; Matsui, T; Okamura, A; Yakushijin, K; Yamamoto, K, 2005
)
"Defibrotide appears to be an effective and relatively safe treatment for children with HVOD."( Defibrotide for the treatment of hepatic veno-occlusive disease in children.
Bulley, SR; Doyle, J; Dupuis, LL; Strahm, B, 2007
)
"Defibrotide (DF) is a polydisperse mixture of 90% single-stranded oligonucleotides with anti-thrombotic and anti-apoptotic functions. "( Defibrotide: an endothelium protecting and stabilizing drug, has an anti-angiogenic potential in vitro and in vivo.
Andreesen, R; Burger, V; Eissner, G; Frei, C; Geissler, EK; Haffner, S; Holler, E; Iacobelli, M; Koehl, GE; Schlitt, HJ, 2007
)
"Defibrotide is a polydeoxyribonucleotide-derived anti-ischemic drug with multiple sites of action involving both plasmatic and cellular targets. "( Defibrotide reduces monocyte PAI-2 and procoagulant activity.
Abbate, R; Attanasio, M; Comeglio, P; Francalanci, I; Gensini, GF; Giusti, B; Gori, AM; Martini, F; Prisco, D; Zarone, N, 1995
)
"Defibrotide is a deoxyribonucleic acid derivative extracted from mammalian organs, which has been developed for the treatment of a number of vascular disorders. "( Defibrotide. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in vascular disorders.
Goa, KL; Palmer, KJ, 1993
)
"1. Defibrotide is a drug which is a mixture of DNA fragments of various lengths. "( Investigation of the fibrinolytic activity of defibrotide fractions.
Bilsel, S; Emerk, K; Hizal, N, 1994
)
"Defibrotide is an antithrombotic and profibrinolytic drug which modulates endothelial function. "( Morphological changes in carotid arteries of rabbits induced by defibrotide infusion.
Bilsel, S; Emerk, K; Erşahin, C; Moini, H; Okar, I; San, T, 1994
)
"Defibrotide is a single-stranded DNA fraction obtained from mammalian lung and is able to increase prostacyclin production by endothelial cells. "( Possible role of defibrotide in endothelial cell protection.
Corsi, M; Ferrero, ME; Gaja, G; Parise, M, 1993
)
"Defibrotide is a polydeoxyribonucleotide extracted from mammalian organs (porcine) and prepared by controlled depolymerization, resulting in a single-stranded deoxyribonucleotide with a mean molecular weight of 15 to 30 kDa. "( Defibrotide as a possible anti-ischemic drug.
Coccheri, S; Nazzari, M, 1996
)
"Defibrotide is a polydeoxyribonucleotide that possesses profibrinolytic and cytoprotective activities. "( Modulation of venous endothelial activity and transcellular calcium transport by defibrotide: the adenosine hypothesis.
Capecchi, PL; Ceccatelli, L; Di Perri, T; Franchi, M; Frigerio, C; Messa, GL; Pasini, FL, 1996
)
"Defibrotide is a polydeoxyribonucleotide sodium salt extracted from mammalian organs. "( An integrated view of the activities of defibrotide.
Ferro, L; Pescador, R; Porta, R, 1996
)
"Defibrotide is a polydeoxyribonucleotide derived agent with a weight average of 15 to 18 kDa. "( Defibrotide mediated inhibition of serotonin, endothelin-I, thromboxane, and serum induced contraction of canine femoral and pulmonary arterial rings.
Fareed, J; Hoppensteadt, DA; Iqbal, O; Yang, LH, 1996
)
"Defibrotide (DF) is a polydeoxyribonucleotide with activity in several vascular disorders and, unlike t-PA and heparin, produces no systemic anticoagulant effects."( Treatment of severe veno-occlusive disease with defibrotide: compassionate use results in response without significant toxicity in a high-risk population.
Antin, JH; Bearman, SI; Elias, AD; Fareed, J; Guinan, EC; Hoppensteadt, D; Iacobelli, M; Kinchla, NM; Krishnan, A; Lill, M; Nath, R; Neuberg, D; Richardson, PG; Soiffer, R; Vredenburgh, J; Waller, EK; Wheeler, C; Woolfrey, AE, 1998
)
"Defibrotide is an antithrombotic drug which enhances prostacyclin production and activates fibrinolytic system. "( Improvement of walking distance by defibrotide in patients with intermittent claudication--results of a randomized, placebo-controlled study (the DICLIS study). Defibrotide Intermittent CLaudication Italian Study.
Coccheri, S; Marubini, E; Nenci, GG; Violi, F, 2000
)
"Defibrotide (DF) is a polydeoxyribonucleotide that has been found to have anti-thrombotic, anti-ischaemic and thrombolytic properties without causing significant anticoagulation."( Defibrotide for the treatment of hepatic veno-occlusive disease: results of the European compassionate-use study.
Barbui, T; Bowyer, K; Chopra, R; Eaton, JD; Finazzi, G; Grassi, A; Iacobelli, M; Neumeister, P; Potter, M; Prentice, HG; Salat, C; Shaw, B, 2000
)
"Defibrotide is a polydeoxyribonucleotide with thrombolytic and antithrombotic properties and no systemic anticoagulant effect."( Defibrotide for the treatment of veno-occlusive disease after liver transplantation.
Bar-Nathan, N; Ben-Ari, Z; Mor, E; Pappo, O; Shaharabani, E; Shapira, Z; Tur-Kaspa, R, 2001
)
"Defibrotide is a promising drug for the treatment of VOD after liver transplantation and needs to be evaluated in large, prospective studies."( Defibrotide for the treatment of veno-occlusive disease after liver transplantation.
Bar-Nathan, N; Ben-Ari, Z; Mor, E; Pappo, O; Shaharabani, E; Shapira, Z; Tur-Kaspa, R, 2001
)
"Defibrotide is a polydeoxyribonucleotide sodium salt with antithrombotic properties. "( A novel insight into the mechanism of the antithrombotic action of defibrotide.
Bianchi, G; Kato, G; Mantovani, M; Pescador, R; Porta, R; Tettamanti, R; Thiemermann, C; Vitte, PA, 1992
)
"Defibrotide is a new antithrombotic and fibrinolytic drug which is obtained by controlled depolymerization of mammalian DNA. "( Subcellular localization of radioactively labelled defibrotide in cultured endothelial cells.
Bilsel, S; Emerk, K; Erşahin, C; Taga, Y, 1992
)
"Defibrotide is a polydeoxyribonucleotide with antithrombotic effects in experimental animal models. "( Defibrotide inhibits platelet activation by cathepsin G released from stimulated polymorphonuclear leukocytes.
Cerletti, C; de Gaetano, G; Evangelista, V; Piccardoni, P, 1992
)
"Defibrotide (DEF) is a polydeoxyribonucleotide agent provided with profibrinolytic and antithrombotic properties. "( Defibrotide inhibits Ca2+ dependent neutrophil activation: implications for its pharmacological activity in vascular disorders.
Capecchi, PL; Ceccatelli, L; Di Perri, T; Pasini, FL; Pasqui, AL, 1991
)
"Defibrotide is a polydeoxyribonucleotide drug known to modulate the endothelial cell release of t-PA, PAI, and PGI-2 and to improve blood flow and perfusion. "( A double-blind, multicenter, placebo-controlled, dose comparison study of orally administered defibrotide: preliminary results in patients with peripheral arterial disease.
Albano, O; Allegra, C; Arpaia, MR; Binaghi, F; Carlizza, A; Del Guercio, R; Fareed, J; Fronteddu, F; Sabbá, C; Strano, A, 1991
)
"Defibrotide is a polydeoxyribonucleotide salt that shows antithrombotic activity through a suggested profibrinolytic mechanism. "( Fibrinolytic effects of defibrotide in atherosclerotic patients.
Boeri, G; Girolami, A; Patrassi, GM; Sartori, MT; Scapinello, MP; Viero, ML, 1991
)
"Defibrotide is a single-stranded polydeoxyribonucleotide obtained from deoxyribonucleic acid of mammalian lungs by controlled depolimerization."( The pharmacology and clinical pharmacology of defibrotide: a new profibrinolytic, antithrombotic and anti-platelet substance.
Balkuv-Ulutin, S; Cizmeci, G; Ozsoy, Y; Ugur, MS; Ulutin, ON; Ulutin, T, 1990
)
"Defibrotide is a profibrinolytic and antithrombotic drug which seems to modulate endothelial cell function. "( Interaction of 3H-defibrotide with cultured human umbilical vein endothelial cells.
Bilsel, S; Emerk, K; Taga, Y; Yalçin, AS, 1990
)
"Defibrotide is a derivative of polydeoxyribonucleotide extracted from bovine lung. "( Clinical pharmacology and mode of action of a new antithrombotic compound: Defibrotide.
Balkuv-Ulutin, S; Cizmeci, G; Ulutin, ON, 1988
)
"Defibrotide (DEF) is a product of the controlled hydrolysis of DNA from mammalian lungs. "( Prostacyclin and the mechanism of action of defibrotide.
Gryglewski, RJ; Marcinkiewicz, E; Radomski, M; Swies, J, 1989
)
"Defibrotide is a new compound with antithrombotic and profibrinolytic activity. "( Clinical evaluation of defibrotide in the treatment of arterial and venous vascular disease. A preliminary report.
Belcaro, G; Cianchetti, E; Cipollone, G; Errichi, BM; Gaspari, AL; Lania, M; Laurora, G; Legnini, M; Leone, L; Melena, E,
)
"Defibrotide is a polydeoxyribonucleotide of mammalian origin which possesses profibrinolytic effect and PGI2-releasing capacity. "( Beneficial effects of defibrotide against myocardial ischemia and decline of beta-adrenoceptor function in the rabbit.
Berti, F; Mandelli, C; Niada, R; Omini, C; Pretolani, M; Rossoni, G, 1986
)
"Defibrotide (D) is a natural polydeoxyribonucleotide from mammalian lungs with profibrinolytic and antithrombotic activities. "( Protective activity of defibrotide against lethal acute myocardial ischemia in the cat.
Mantovani, M; Niada, R; Pescador, R; Porta, R; Prino, G, 1986
)
"Defibrotide is a polynucleotide extracted from mammalian lung, which shows antithrombotic and anti-ischaemic activity in animals, probably related to stimulation of fibrinolysis and/or enhancement of prostacyclin production. "( Acute effects of defibrotide, an experimental antithrombotic agent, on fibrinolysis and blood prostanoids in man.
Biagi, G; Bianchini, B; Coccheri, S; Grauso, F; Legnani, C, 1988
)
"Defibrotide is a profibrinolytic agent which has potent stimulatory effects on vascular prostacyclin (PGI2) production and secretion. "( Morphometric and ultrastructural study of experimental venous thrombosis. Effects of defibrotide, an antithrombotic agent.
Angelaccio, E; Clementi, F; Fumagalli, G; Lombardo, N, 1987
)
"Defibrotide (D) is a polydeoxyribonucleotide of mammalian origin that has no anticoagulant activity or hemodynamic effects but has considerable profibrinolytic and antithrombotic activities under several experimental conditions. "( Defibrotide is antithrombotic and thrombolytic against rabbit venous thrombosis.
Mantovani, M; Niada, R; Pescador, R; Porta, R; Prino, G, 1986
)
"Defibrotide is a new drug with antithrombotic and profibrinolytic activities but without anticoagulant activity and major side effects."( Defibrotide therapy for thrombophlebitis--controlled clinical trial.
Cappelli, R; Di Perri, T; Messa, GL; Vittoria, A, 1986
)
"Defibrotide is a partially depolymerized DNA fraction, having a molecular weight of about 20,000 and possessing antithrombotic and fibrinolytic activities. "( Selective stimulation of coronary vascular PGI2 but not of platelet thromboxane formation by defibrotide in the platelet perfused heart.
Löbel, P; Schrör, K, 1985
)

Effects

Defibrotide has a spectrum of interesting pharmacological properties that make this drug very useful for the treatment of arterial and venous thrombotic diseases. The drug has an acceptable safety profile with an improved response in severe/very severe SOS compared with historical controls.

Defibrotide has been approved for the treatment of individuals with severe sinusoidal obstruction syndrome following haematopoietic stem cell transplantation in the European Union and the United States. It has shown promising efficacy treating hepatic VOD/SOS with MOF in phase 2 studies.

ExcerptReference
"Defibrotide has an acceptable safety profile with an improved response in severe/very severe SOS compared with historical controls, mainly in pediatric patients. "( Defibrotide in hematopoietic stem cell transplantation: A multicenter survey study of the Spanish Hematopoietic Stem Cell Transplantation Group (GETH).
Badell, I; Beléndez, C; Benito, A; Bento, L; Costilla, L; Díaz de Heredia, C; Díaz, MÁ; Duarte, M; Espigado, I; Esquirol, A; Fernández, JM; Gallardo, AI; García, E; Gómez Centurión, I; González de Pablo, J; González Vicent, M; González, P; Guerreiro, M; Jiménez Ubieto, A; Jiménez, MJ; Lavilla, E; López Corral, L; López, O; Marsal, J; Molina, B; Palomo, P; Pedraza, A; Pérez Martinez, A; Pérez, A; Regueiro, A; Vallejo, C, 2021
)
"Defibrotide has a spectrum of interesting pharmacological properties that make this drug very useful for the treatment of arterial and venous thrombotic diseases."( An integrated view of the activities of defibrotide.
Ferro, L; Pescador, R; Porta, R, 1996
)
" Defibrotide has shown efficacy in treatment of SOS/VOD."( Defibrotide Shows Efficacy in the Prevention of Sinusoidal Obstruction Syndrome After Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Study.
Ansari, M; Beauverd, Y; Bernard, F; Chalandon, Y; Dantin, C; de Ramon Ortiz, C; Giannotti, F; Mahne, E; Mamez, AC; Mappoura, M; Masouridi-Levrat, S; Morin, S; Simonetta, F; Stephan, C, 2022
)
"Defibrotide has been approved in several geographic jurisdictions for the treatment of hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) for years. "( Efficacy and Safety of Defibrotide for the Treatment of Hepatic Veno-Occlusive Disease after Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis.
Han, Y; Pan, T; Qi, J; Ruan, C; Yang, L; You, T, 2019
)
"Defibrotide has shown proven benefit in its treatment and may have a modest role in prevention."( Defibrotide treatment but not prophylaxis is useful in hepatic sinusoidal obstruction syndrome in children undergoing autologous stem cell transplant following high-dose chemotherapy: A single-center experience from the Royal Marsden Hospital, UK.
Johnson, I; Mycroft, J; Petterson, T; Roy Moulik, N; Vaidya, SJ; Van Bruggen, L, 2020
)
"Defibrotide (DF) has been approved for the treatment of individuals with severe sinusoidal obstruction syndrome following haematopoietic stem cell transplantation in the European Union and the United States."( Defibrotide Stimulates Angiogenesis and Protects Endothelial Cells from Calcineurin Inhibitor-Induced Apoptosis via Upregulation of AKT/Bcl-xL.
Hashimoto, Y; Ikezoe, T; Ohkawara, H; Pan, B; Wang, X; Xu, K; Zeng, L, 2018
)
"Defibrotide has shown promising efficacy treating hepatic VOD/SOS with MOF in phase 2 studies."( Phase 3 trial of defibrotide for the treatment of severe veno-occlusive disease and multi-organ failure.
Antin, JH; Arai, S; Bajwa, R; Brochstein, JA; Champlin, R; D'Agostino, RB; Doyle, J; Duerst, R; Gillio, A; Giralt, S; Grupp, SA; Guinan, EC; Hannah, AL; Hume, RL; Iacobelli, M; Kernan, NA; Krishnan, A; Lehmann, L; Martin, PL; Massaro, J; Miloslavsky, M; Mineishi, S; Nejadnik, B; Nemecek, ER; Richardson, PG; Riches, ML; Rodriguez, T; Smith, A; Soiffer, RJ; Steinbach, G; Termuhlen, AM; Warren, D, 2016
)
"Defibrotide has been used effectively in the treatment of endothelial complications of allogeneic stem cell transplantation and recent preclinical evidences suggest an antiangiogenic effect and an anticancer activity. "( Defibrotide: a review on clinical use and future development.
Boccadoro, M; Cavallo, F; Larocca, A; Magarotto, V; Palumbo, A; Patriarca, F; Rossi, D, 2008
)
"Defibrotide (DF) has been shown in Phase II and III trials to improve complete response in patients with severe VOD (sVOD)."( Drug safety evaluation of defibrotide.
Carreras, E; Corbacioglu, S; Giralt, S; Ho, VT; Holler, E; Hoyle, M; Kernan, NA; Lehmann, L; Maglio, M; Maguire, C; Niederwieser, D; Richardson, PG; Sardella, M; Soiffer, R, 2013
)
"Defibrotide (Df) has been reported to protect various organs from ischemic damage. "( Functional and morphological effects of defibrotide on renal ischemia.
Amodio, P; Ancona, E; Baldan, N; Comandella, MG; Ganz, E; Pittoni, G; Rigotti, P; Valente, M, 1993
)
"Defibrotide has been evaluated in patients with peripheral arterial disease (PAD) of the lower limbs, with coronary artery disease (CAD), and with Raynaud's phenomenon (RP). "( Clinical trials with defibrotide in vascular disorders.
Cimminiello, C, 1996
)
"Defibrotide has been demonstrated to produce profibrinolytic, cytoprotective and vasofacilatory activities."( Treatment of nonproliferative diabetic retinopathy with Defibrotide in noninsulin-dependent diabetes mellitus: a pilot study.
De Mattia, G; Forte, R; Giusti, C; Laurenti, O; Pannarale, MR; Vingolo, EM, 1999
)
"Defibrotide (DF) has been proposed as a new antithrombotic agent in renal transplantation. "( Effects of defibrotide on renal function and urinary prostanoid excretion in ciclosporin-treated rats.
Amodio, P; Angeli, P; Borsato, M; Ferraresso, M; Menon, F; Morpurgo, E; Rigotti, P; Sacerdoti, D, 1991
)
"Defibrotide has been found to modulate endothelial cell function causing increase in t-PA production and release with correction the defect in Cuff test in vascular disorders."( Clinical pharmacology and mode of action of a new antithrombotic compound: Defibrotide.
Balkuv-Ulutin, S; Cizmeci, G; Ulutin, ON, 1988
)

Actions

Defibrotide is known to enhance prostacyclin (PGI2) release from the vascular endothelium. It does not increase bleeding risk.

ExcerptReference
"Defibrotide displays a cardioprotection by increasing PGI2 release and by reducing TXB2 in the blood."( Nitric oxide and prostacyclin pathways: an integrated mechanism that limits myocardial infarction progression in anaesthetized rats.
Berti, F; Brini, AT; Clement, MG; De Gennaro Colonna, V; Manfredi, B; Polvani, G; Rossoni, G, 2006
)
"Defibrotide does not increase bleeding risk."( Clinical trials with defibrotide in vascular disorders.
Cimminiello, C, 1996
)
"Defibrotide is known to enhance prostacyclin (PGI2) release from the vascular endothelium. "( Coronary endothelium-protective effects of defibrotide in ischaemia and reperfusion.
Aoki, N; Lefer, AM; Mulloy, D, 1990
)

Treatment

Defibrotide was used for treatment of all with SOS and prophylactically in patients receiving busulfan-based conditioning until 2014. Patients spent 30% of their stay in the intensive care unit vs 60% in BSC patients.

ExcerptReference
"Defibrotide was used for treatment of all with SOS and prophylactically in patients receiving busulfan-based conditioning until 2014."( Defibrotide treatment but not prophylaxis is useful in hepatic sinusoidal obstruction syndrome in children undergoing autologous stem cell transplant following high-dose chemotherapy: A single-center experience from the Royal Marsden Hospital, UK.
Johnson, I; Mycroft, J; Petterson, T; Roy Moulik, N; Vaidya, SJ; Van Bruggen, L, 2020
)
"Defibrotide-treated patients spent 30% of their stay in the intensive care unit vs 60% in BSC patients."( Cost-effectiveness analysis of defibrotide in the treatment of patients with severe veno-occlusive disease/sinusoidal obstructive syndrome with multiorgan dysfunction following hematopoietic cell transplantation in Spain.
Artola Urain, T; Calvo Hidalgo, M; Carcedo Rodriguez, D; Chinea Rodriguez, A; García Torres, E; González Vicent, M; Gutiérrez García, G; Regueiro García, A; Villacampa, A,
)
"3. Defibrotide treatment resulted in a significant inhibition of postreperfusion superoxide generation, lipid peroxidation, serum ALT activity, serum LDH activity, MPO activity, serum nitrite/nitrate level, leukocyte adherence to SMA, and Kupffer cell mobilization, indicating a significant attenuation of hepatic dysfunction."( Effects of defibrotide, a novel oligodeoxyribonucleotide, on ischaemia and reperfusion injury of the rat liver.
Choi, MS; Kim, KJ; Oh, BK; Shin, YK; Sohn, UD; Song, JH, 2002
)
"Defibrotide/rhG-CSF treatment compared to rhG-CSF alone increased CFCs, HPP-CFCs, and LTC-ICs by 1.4- (35,089 vs 25,825, p< or =0.02), 6- (4358 vs 748, p< or =0.02), and 5-fold (884 vs 168, p< or =0.04), respectively."( Mobilization of primitive and committed hematopoietic progenitors in nonhuman primates treated with defibrotide and recombinant human granulocyte colony-stimulating factor.
Carlo-Stella, C; Cleris, L; Di Nicola, M; Formelli, F; Gianni, AM; Guidetti, A; Haanstra, K; Jonker, M; Longoni, P; Magni, M; Milanesi, M; Milani, R, 2004
)
"Defibrotide treatment significantly protected ischaemic kidneys from the drop in ATP intrarenal content (1465 +/- 147 vs."( Antiischaemic effect of defibrotide treatment in rat kidney.
Corsi, M; Ferrero, ME; Gaja, G; Parise, M, 1993
)
"In defibrotide-treated preparations, inhibition of PAF formation was associated with a pronounced stimulation of 6-keto-PGF1 alpha generation, which was particularly marked on reperfusion (from 27.4 +/- 1.8 to 197.5 +/- 8.2 ng/min)."( Production and biologic interactions of prostacyclin and platelet-activating factor in acute myocardial ischemia in the perfused rabbit heart.
Berti, F; De Angelis, L; Galli, G; Magni, F; Rossoni, G, 1990
)
"Defibrotide-treated patients showed a fast disappearance of clinical and instrumental signs of thrombophlebitis."( Defibrotide therapy for thrombophlebitis--controlled clinical trial.
Cappelli, R; Di Perri, T; Messa, GL; Vittoria, A, 1986
)
"Treatment with defibrotide was generally well tolerated, and drug-related toxicities were consistent with previous studies."( Defibrotide for Patients with Hepatic Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome: Interim Results from a Treatment IND Study.
Antin, JH; Grupp, SA; Hannah, AL; Hume, R; Iacobelli, M; Kernan, NA; Lehmann, L; Miloslavsky, M; Nejadnik, B; Richardson, PG; Shore, T; Smith, AR; Soiffer, RJ; Triplett, BM, 2017
)
"Treatment with defibrotide was conducted in the context of an investigational phase II protocol where the dose was regulated and individualized by disease/patient-specific molecular and clinical markers."( Treatment of catastrophic antiphospholipid syndrome with defibrotide, a proposed vascular endothelial cell modulator.
Asherson, R; Burcoglu-O'Ral, A; Erkan, D, 2002
)
"Treatment with defibrotide in addition to elastic compression in patients with objectively assessed CDVI, mostly due to PTS, resulted in clinical benefits and prevented thrombotic complications harmful to the limb conditions."( Effects of defibrotide in patients with chronic deep insufficiency. The PROVEDIS study.
Andreozzi, GM; Coccheri, S; D'Addato, M; Gensini, GF, 2004
)
"Treatment with defibrotide significantly protected against the decrease in spectral power (-30% +/- 7) and cell loss (-9%)."( Polydeoxyribonucleotide (defibrotide) protects against post-ischemic behavioral, electroencephalographic and neuronal damage in the gerbil.
Gori, E; Lampugnani, P; Leone, MP; Matturri, L; Sala, M, 1997
)

Toxicity

Defibrotide proved safe and effective in resolving clinical symptoms and normalizing serological findings in the syndrome.

ExcerptReference
" Defibrotide proved safe and effective in resolving clinical symptoms and normalizing serological findings in the syndrome."( Hepatic veno-occlusive disease during chemotherapy for nephroblastoma: successful and safe treatment with defibrotide. Report of a clinical case.
Arcamone, G; Cecinati, V; De Leonardis, F; De Mattia, D; Giordano, P; Grassi, M; Santoro, N, 2009
)
"Defibrotide appears to be a safe prophylaxis for SOS."( Safety and effects of prophylactic defibrotide for sinusoidal obstruction syndrome in hematopoietic stem cell transplantation.
Eom, HS; Ghim, TT; Kong, SY; Kwon, YJ; Lee, HW; Lim, YJ; Park, BK; Park, HJ; Park, JA; Park, M; Yoon, JH; Yun, T, 2013
)
" Survival rate at day + 100 post-HSCT (D + 100 SR), as well as the prognosis, comprising complete response (CR), adverse events including ≥1 adverse event (≥1 AE), hemorrhage, and serious adverse events (SAEs), were pooled using a random effect model."( Efficacy and Safety of Defibrotide for the Treatment of Hepatic Veno-Occlusive Disease after Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis.
Han, Y; Pan, T; Qi, J; Ruan, C; Yang, L; You, T, 2019
)
" No unexpected defibrotide-related safety findings and defibrotide-related treatment-emergent adverse events or deaths were reported."( A phase 2 trial of defibrotide for the prevention of chimeric antigen receptor T-cell-associated neurotoxicity syndrome.
Agarwal, S; Amber, V; Arnason, J; Jacobson, CA; Rosenthal, AC; Wu, W; Yared, JA; Zhang, P, 2023
)

Pharmacokinetics

A pharmacokinetic study of defibrotide, an antithrombotic polydeoxyribonucleotide extract, was performed in 5 healthy volunteers after rapid intravenous injection.

ExcerptReference
" A pharmacokinetic study of the antithrombotic, profibrinolytic, polydeoxyribonucleotidic drug defibrotide was carried out by evaluating the plasma drug levels by these three methods."( High-performance liquid chromatography determination of polydeoxyribonucleotides in plasma: its application to the determination of defibrotide's pharmacokinetics in the rabbit.
Lanzarotti, E; Mantovani, M; Moltrasio, D; Pescador, R; Porta, R; Prino, G, 1992
)
" After single intravenous or oral administration of [125I]-D or [32P]-D the pharmacokinetic parameters for the two labels were generally in good agreement (75%)."( Study on pharmacokinetics of radioactive labelled defibrotide after oral or intravenous administration in rats.
Ferro, L; Fisher, J; Holland, TK; Pescador, R; Porta, R, 1996
)

Compound-Compound Interactions

ExcerptReference
" We investigated the activity of Defibrotide alone or in combination with recombinant human granulocyte colony-stimulating factor (rhG-CSF) to mobilize peripheral blood progenitor cells (PBPCs) in BALB/c mice."( Defibrotide in combination with granulocyte colony-stimulating factor significantly enhances the mobilization of primitive and committed peripheral blood progenitor cells in mice.
Carlo-Stella, C; Cleris, L; Di Nicola, M; Formelli, F; Gianni, MA; Longoni, P; Magni, M; Milanesi, M; Stucchi, C, 2002
)
" Our preliminary results suggest that DF may act as a global endothelial protectant and decrease the risk of GvHD in combination with rATLG, PTCy and CsA."( Defibrotide combined with triple therapy including posttransplant cyclophosphamide, low dose rabbit anti-t-lymphocyte globulin and cyclosporine is effective in prevention of graft versus host disease after allogeneic peripheral blood stem cell transplanta
Akpinar, S; Kayikci, O; Tekgunduz, E, 2022
)

Bioavailability

Defibrotide is an orally bioavailable polydisperse oligonucleotide. It has promising activity in hepatic veno-occlusive disease, stem cell transplantation-related toxicity characterized by microangiopathy.

ExcerptReference
" Bioavailability studies gave evidence that the drug is absorbed by 50-70% when administered orally."( Effects of defibrotide after oral and parenteral administration in patients with peripheral obliterative arterial disease (POAD).
Craveri, A; Gallo, E; Landi, G; Paganardi, L; Passaretti, B; Ranieri, R; Stanzani, M; Tornaghi, G,
)
" Bioavailability was apparently 58%."( Pharmacokinetics, absorption, distribution and disposition of [125I]-defibrotide following intravenous or oral administration in the rat.
Fisher, J; Holland, TK; Johnston, AM; Mantovani, M; McCallum, J; Pescador, R; Prino, G, 1993
)
"Defibrotide, an orally bioavailable polydisperse oligonucleotide, has promising activity in hepatic veno-occlusive disease, a stem cell transplantation-related toxicity characterized by microangiopathy."( Preclinical studies in support of defibrotide for the treatment of multiple myeloma and other neoplasias.
Anderson, KC; Boccadoro, M; Distaso, M; Echart, C; Iacobelli, M; Menon, K; Mitsiades, CS; Palumbo, A; Richardson, PG; Rouleau, C; Teicher, B, 2009
)
"Defibrotide is a novel orally bioavailable polydisperse oligonucleotide with anti-thrombotic and anti-adhesive effects."( Melphalan, prednisone, thalidomide and defibrotide in relapsed/refractory multiple myeloma: results of a multicenter phase I/II trial.
Anderson, K; Benevolo, G; Boccadoro, M; Bringhen, S; Cavallo, F; Gaidano, G; Gay, F; Genuardi, M; Iacobelli, M; Kotwica, K; Larocca, A; Magarotto, V; Masini, L; Mitsiades, C; Palumbo, A; Richardson, P; Rossi, D; Rus, C, 2010
)

Dosage Studied

The overall gain of walking distance after maintenance therapy with the reduced defibrotide dosage amounted to approximately + 50% over basal (after 180 days) The results of this preliminary clinical trial confirm the thrombolytic effect of defib rotide demonstrated in preclinical models.

ExcerptReference
" Thus, aim of this trial was to evaluate whether the drug might exert similar clinical and biological effects after oral/parenteral dosing in a 2:1 ratio."( Effects of defibrotide after oral and parenteral administration in patients with peripheral obliterative arterial disease (POAD).
Craveri, A; Gallo, E; Landi, G; Paganardi, L; Passaretti, B; Ranieri, R; Stanzani, M; Tornaghi, G,
)
" According to the dose-response curves for isoproterenol and tyramine, left ventricular dP/dtmax was significantly depressed in infarcted hearts, whereas the dose-response curve for the inotropic effect of phenylephrine was markedly enhanced."( Defibrotide, an antithrombotic substance that preserves postsynaptic alpha- and beta-adrenergic function in post acute infarcted rabbit hearts.
Berti, F; Folco, G; Niada, R; Omini, C; Rossoni, G; Tondo, C,
)
"In an open-study design five healthy volunteers were first given 2500 IU sodium heparin intravenously and then, after 72 h, another injection of the same dosage of sodium heparin followed immediately by 400 mg defibrotide intravenously."( Effects of a defibrotide-heparin combination on some measures of haemostasis in healthy volunteers.
Fowst, C; Girardello, R; Marelli, C; Pogliani, EM; Salvatore, M,
)
" These preliminary results suggest that defibrotide may prove beneficial to patients with PVD; further studies are needed to find the most appropriate dosage regime."( A pilot evaluation of the effect of defibrotide in patients affected by peripheral arterial occlusive disease.
Albano, O; Dina, F; Nazzari, M; Sabbá, C; Zupo, V, 1988
)
" In NL-AMI, pretreatment of cats with D at the same dosage (intravenous infusion) reduced AMI-ST segment increases and AMI changes in hemodynamics."( Cardioprotective effects of defibrotide in acute lethal and nonlethal myocardial ischemia in the cat.
Berti, F; Mantovani, M; Niada, R; Pescador, R; Porta, R; Prino, G, 1986
)
" The dose-response curves for elimination indicated saturation."( Pharmacokinetics of defibrotide in healthy volunteers.
Ferrari, D; Fragiacomo, C; Noseda, G, 1986
)
" The dose-response curves for elimination parameters were powers with a negative exponent indicating considerable saturation of this process."( Pharmacokinetics of Defibrotide and of its profibrinolytic activity in the rabbit.
Madonna, M; Mantovani, M; Pescador, R; Prino, G, 1983
)
" The overall gain of walking distance after maintenance therapy with the reduced defibrotide dosage amounted to approximately + 50% over basal (after 180 days)."( Effects of defibrotide on physical performance and hemorheologic picture in patients with peripheral arteriopathy.
Corsi, C; Giordano, S; Leanza, D; Marrapodi, E; Nazzari, M, 1994
)
" The dosage was 15 mg/kg/day in 4 divided doses, which was increased gradually (in 3 days) to 40 mg/kg/day in 4 divided doses."( Hepatic veno-occlusive disease during chemotherapy for nephroblastoma: successful and safe treatment with defibrotide. Report of a clinical case.
Arcamone, G; Cecinati, V; De Leonardis, F; De Mattia, D; Giordano, P; Grassi, M; Santoro, N, 2009
)
"This was a Phase 1 trial in which dogs with spontaneous tumors received STA-1474 under one of three different dosing schemes."( Phase I evaluation of STA-1474, a prodrug of the novel HSP90 inhibitor ganetespib, in dogs with spontaneous cancer.
Barsoum, J; Bear, MD; Foley, KP; Inoue, T; London, CA; McCleese, J; Paalangara, R; Ying, W, 2011
)
" Defibrotide is considered a safe and effective treatment when dosed at 25 mg/kg/day."( Escalation to High-Dose Defibrotide in Patients with Hepatic Veno-Occlusive Disease.
Kang, G; Kuttab, HI; Leung, W; Triplett, BM, 2015
)
" In Part 2, defibrotide exposure parameters in six subjects with severe/ESRD after multiple doses (AUC0-t, 113 µg·h/mL; AUC over dosing interval, 113 µg·h/mL; Cmax, 53."( Pharmacokinetic profile of defibrotide in patients with renal impairment.
Eller, M; Marbury, TC; Marier, JF; Tocchetti, P; Tudone, E; Zomorodi, K, 2016
)
" Patient outcome data from the larger studies and compassionate programs can inform consensus recommendations on dosing regimen and criteria for the treatment of VOD/SOS with defibrotide in the adult population."( Defibrotide for the management of sinusoidal obstruction syndrome in patients who undergo haemopoietic stem cell transplantation.
Avery, S; Coutsouvelis, J; Dooley, M; Kirkpatrick, C; Spencer, A, 2016
)
" Early diagnosis, prompt initiation of defibrotide, and minimization of dosing interruptions may be key to successful treatment of VOD/SOS."( Defibrotide: real-world management of veno-occlusive disease/sinusoidal obstructive syndrome after stem cell transplant.
Antin, JH; Cutler, C; Gooptu, M; Ho, VT; Kim, HT; Koreth, J; Nauffal, M; Nikiforow, S; Richardson, PG; Romee, R; Soiffer, RJ, 2022
)
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (434)

TimeframeStudies, This Drug (%)All Drugs %
pre-199082 (18.89)18.7374
1990's120 (27.65)18.2507
2000's79 (18.20)29.6817
2010's93 (21.43)24.3611
2020's60 (13.82)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials76 (16.38%)5.53%
Reviews68 (14.66%)6.00%
Case Studies43 (9.27%)4.05%
Observational6 (1.29%)0.25%
Other271 (58.41%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (22)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
Defibrotide in the Human Endotoxemia Model -- an Exploratory Trial Investigating the Effects and the Mechanisms of Defibrotide[NCT02876601]Phase 420 participants (Actual)Interventional2017-04-18Completed
Defibrotide Therapy for SARS-CoV2 Acute Respiratory Distress Syndrome (ARDS)[NCT04530604]Phase 113 participants (Actual)Interventional2020-10-01Completed
A Phase 3, Randomized, Adaptive Study Comparing the Efficacy and Safety of Defibrotide vs Best Supportive Care in the Prevention of Hepatic Veno-Occlusive Disease in Adult and Pediatric Patients Undergoing Hematopoietic Stem Cell Transplant[NCT02851407]Phase 3372 participants (Actual)Interventional2016-09-01Completed
Prospective, Multicenter, Open-Label, Single Arm, Phase 2 Study to Evaluate the Safety and Efficacy of Defibrotide in the Prevention of Chimeric Antigen Receptor-T-cell-associated Neurotoxicity in Subjects With Relapsed or Refractory Diffuse Large B-cell [NCT03954106]Phase 225 participants (Actual)Interventional2019-10-04Terminated(stopped due to Primary endpoint would unlikely to be met based on the unplanned interim assessment on the first 20 efficacy evaluable patients.)
A Pilot Trial of Using Pre-Transplant Risk Stratification and Prophylactic Defibrotide to Prevent Serious Thrombotic Microangiopathy in High-Risk Hematopoietic Stem Cell Transplant Patients[NCT03384693]Phase 225 participants (Actual)Interventional2018-05-01Completed
A Phase 2, Prospective, Randomized, Open-Label Study on the Efficacy of Defibrotide Added to Standard of Care Immunoprophylaxis for the Prevention of Acute Graft-versus-Host-Disease in Adult and Pediatric Patients After Allogeneic Hematopoietic Stem Cell [NCT03339297]Phase 2152 participants (Actual)Interventional2018-02-21Completed
Use of Defibrotide to Reduce Progression of Acute Respiratory Failure Rate in Patients With COVID-19 Pneumonia[NCT04335201]Phase 250 participants (Actual)Interventional2020-05-20Completed
A Single-Arm Safety and Feasibility Study of Defibrotide for the Treatment of Severe COVID-19[NCT04652115]Phase 242 participants (Anticipated)Interventional2021-01-01Recruiting
Compassionate Use of Defibrotide for Patients With Veno-Occlusive Disease[NCT00143546]0 participants Expanded Access2003-11-30No longer available
Phase II Open Label Study to Assess Efficacy of 5-day Defibrotide Treatment for Hepatic SOS/VOD[NCT04313036]Phase 224 participants (Anticipated)Interventional2021-03-11Recruiting
Defibrotide for Hematopoietic Stem Cell Transplant Patients With Severe Hepatic Venocclusive Disease: A Phase I/II Study to Determine the Minimal Effective Dose[NCT00003966]Phase 2151 participants (Actual)Interventional2000-04-30Completed
Defibrotide Prophylaxis of Transplant Associated-Thrombotic Microangiopathy in Patients With High-Risk Neuroblastoma Receiving Tandem Transplants[NCT06182410]Phase 215 participants (Anticipated)Interventional2024-03-01Not yet recruiting
A Phase I/II, Multi-Center, Open Label Study of Melphalan, Prednisone, Thalidomide and Defibrotide in Advanced and Refractory Multiple Myeloma Patients[NCT00406978]Phase 1/Phase 224 participants (Actual)Interventional2006-02-28Completed
Defibrotide for the Treatment of Severe Hepatic Veno-Occlusive Disease in Hematopoetic Stem Cell Transplant Patients: A Historically-Controlled, Multi-Center Phase 3 Study to Determine Safety & Efficacy[NCT00358501]Phase 3134 participants (Actual)Interventional2006-07-31Completed
Defibrotide Compassionate Use Protocol for Patients With Life Threatening Veno-Occlusive Disease of the Liver[NCT00263978]0 participants Expanded Access2005-11-30No longer available
Prospective Randomized Study of the Incidence and Outcome of Veno-Occlusive Disease (VOD) With the Prophylactic Use of Defibrotide (DF) in Pediatric Stem Cell Transplantation[NCT00272948]Phase 2/Phase 3360 participants (Anticipated)Interventional2005-12-31Completed
Safety and Efficacy of Prophylactic Defibrotide in Children, Adolescents, and Young Adults With Sickle Cell Disease or Beta Thalassemia Following MAC and Haploidentical Stem Cell Transplantation Utilizing CD34 Enrichment and T-Cell (CD3) Addback[NCT02675959]Phase 240 participants (Anticipated)Interventional2017-07-01Recruiting
A Pilot Study to Determine the Safety of Defibrotide in Children With High Risk Kawasaki Disease[NCT04777422]Phase 22 participants (Actual)Interventional2021-02-24Active, not recruiting
Phase IIb Prospective, Multi-center, Randomized, Parallel, Double Blind, Placebo Controlled Trial to Evaluate Defibrotide Intravenous Infusion in the Prevention and Treatment of COVID-19 Respiratory Distress and Cytokine Release Syndrome[NCT04348383]Phase 2156 participants (Actual)Interventional2020-04-08Completed
Defibrotide for Patients With Hepatic Veno-occlusive Disease: A Treatment IND Study[NCT00628498]Phase 31,206 participants (Actual)Interventional2007-12-31Completed
A Phase II Intrapatient Open-Label Dose Escalation Trial of Defibrotide in Hematopoietic Cell Transplantation (HCT) Recipients With Sinusoidal Obstructive Syndrome (SOS) Post-HCT Associated With Either Renal and/or Pulmonary Dysfunction With Either Refrac[NCT05987124]Phase 220 participants (Anticipated)Interventional2023-12-01Not yet recruiting
A Phase II Study to Determine the Safety of Defibrotide in Sickle Cell Disease-Related Acute Chest Syndrome[NCT03805581]Phase 220 participants (Actual)Interventional2018-01-12Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

TrialOutcome
NCT00358501 (5) [back to overview]Complete Response by Day+100 Post Hematopoietic Stem Cell Transplant
NCT00358501 (5) [back to overview]Survival at Day+100 Following Hematopoietic Stem Cell Transplant
NCT00358501 (5) [back to overview]Percentage of Participants With Treatment-Emergent Adverse Events
NCT00358501 (5) [back to overview]Survival at Day+180 Post Hematopoietic Stem Cell Transplantation
NCT00358501 (5) [back to overview]Historical Control Group Adverse Event Information
NCT00628498 (1) [back to overview]Survival by Day+100 Post Stem Cell Transplant or Chemotherapy
NCT02851407 (37) [back to overview]Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 8 and ≤ 15 Years: Mobility
NCT02851407 (37) [back to overview]Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 8 and ≤ 15 Years: Pain
NCT02851407 (37) [back to overview]Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 8 and ≤ 15 Years: Self-Care
NCT02851407 (37) [back to overview]Maximum Plasma Concentration (Cmax) of Defibrotide Prophylaxis During the Prophylaxis Phase
NCT02851407 (37) [back to overview]Mean Clearance of Defibrotide Prophylaxis During the Prophylaxis Phase
NCT02851407 (37) [back to overview]Non-Relapse Mortality (NRM) for Defibrotide (DP) and Best Supportive Care (BSC) by Days +100 and +180 Post-Hematopoietic Stem Cell Transplant (HSCT)
NCT02851407 (37) [back to overview]Number of Participants With Graft Failure During the Prophylaxis Phase and Rescue Phase
NCT02851407 (37) [back to overview]Percentage of Participants With Chronic Graft-Versus-Host-Disease (GvHD) by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)
NCT02851407 (37) [back to overview]Percentage of Participants With Grades 2, 3, and 4 Acute Graft-Versus-Host-Disease (GvHD) by Days +30, +100, and +180 Post-Hematopoietic Stem Cell Transplant (HSCT) in the Prophylaxis Phase
NCT02851407 (37) [back to overview]Volume of Distribution of Defibrotide Prophylaxis During the Prophylaxis Phase
NCT02851407 (37) [back to overview]Percentage of Participants With Veno-Occlusive Disease (VOD)-Associated Multi-Organ Dysfunction (MOD) by Days +30 and Days +100 Post-Hematopoietic Stem Cell Transplant (HSCT) in Patients Who Developed VOD
NCT02851407 (37) [back to overview]Percentage of Participants With Veno-Occlusive Disease (VOD) After Day +30 Post-Hematopoietic Stem Cell Transplant (HSCT) up to Days +100 and +180 Post-HSCT
NCT02851407 (37) [back to overview]Area Under the Defibrotide Concentration-Time Curve (AUClast) of Defibrotide Prophylaxis During the Rescue Phase
NCT02851407 (37) [back to overview]Maximum Plasma Concentration (Cmax) of Defibrotide Prophylaxis During the Rescue Phase
NCT02851407 (37) [back to overview]Number of Participants With Neutrophil Engraftment by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)
NCT02851407 (37) [back to overview]Number of Participants With Platelet Engraftment by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)
NCT02851407 (37) [back to overview]Percentage of Participants Who Had Resolution of Veno-Occlusive Disease (VOD) by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)
NCT02851407 (37) [back to overview]Percentage of Participants With Veno-Occlusive Disease (VOD) by Day +30 Post-Hematopoietic Stem Cell Transplant (HSCT)
NCT02851407 (37) [back to overview]Percentage of Participants With Grades 2, 3, and 4 Acute Graft-Versus-Host-Disease (GvHD) by Days +30, +100, and +180 Post-Hematopoietic Stem Cell Transplant (HSCT) in the Rescue Phase
NCT02851407 (37) [back to overview]Veno-Occlusive Disease (VOD)-Free Survival by Day +100 Post-Hematopoietic Stem Cell Transplant (HSCT) Per the Independent Endpoint Adjudication Committee (EPAC)
NCT02851407 (37) [back to overview]Veno-occlusive Disease (VOD)-Free Survival by Day +30 Post-Hematopoietic Stem Cell Transplant (HSCT) Per the Independent Endpoint Adjudication Committee (EPAC)
NCT02851407 (37) [back to overview]Veno-Occlusive Disease (VOD)-Free Survival Rate by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)
NCT02851407 (37) [back to overview]Volume of Distribution of Defibrotide Prophylaxis During the Rescue Phase
NCT02851407 (37) [back to overview]Area Under the Defibrotide Concentration-Time Curve (AUClast) of Defibrotide Prophylaxis During the Prophylaxis Phase
NCT02851407 (37) [back to overview]Change in 5-Level EuroQol-5D (EQ-5D-5L) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Adult Participants Age ≥ 16 Years: Activity
NCT02851407 (37) [back to overview]Change in 5-Level EuroQol-5D (EQ-5D-5L) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Adult Participants Age ≥ 16 Years: Anxiety
NCT02851407 (37) [back to overview]Time to Resolution of Veno-Occlusive Disease (VOD) by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)
NCT02851407 (37) [back to overview]Change in 5-Level EuroQol-5D (EQ-5D-5L) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Adult Participants Age ≥ 16 Years: Pain
NCT02851407 (37) [back to overview]Change in 5-Level EuroQol-5D (EQ-5D-5L) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Adult Participants Age ≥ 16 Years: Self-Care
NCT02851407 (37) [back to overview]Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 4 and ≤ 7 Years: Activity
NCT02851407 (37) [back to overview]Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 4 and ≤ 7 Years: Anxiety
NCT02851407 (37) [back to overview]Change in 5-Level EuroQol-5D (EQ-5D-5L) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Adult Participants Age ≥ 16 Years: Mobility
NCT02851407 (37) [back to overview]Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 4 and ≤ 7 Years: Pain
NCT02851407 (37) [back to overview]Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 4 and ≤ 7 Years: Self-Care
NCT02851407 (37) [back to overview]Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 8 and ≤ 15 Years: Activity
NCT02851407 (37) [back to overview]Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 8 and ≤ 15 Years: Anxiety
NCT02851407 (37) [back to overview]Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 4 and ≤ 7 Years: Mobility
NCT02876601 (11) [back to overview]Plasmin-Antiplasmin Complexes
NCT02876601 (11) [back to overview]Plasminogen Activator Inhibitor 1
NCT02876601 (11) [back to overview]Prothrombin Fragments f1+2
NCT02876601 (11) [back to overview]Thrombin-Antithrombin Complexes
NCT02876601 (11) [back to overview]Tissue-type Plasminogen Activator
NCT02876601 (11) [back to overview]Tumor Necrosis Factor (TNF)-Alpha
NCT02876601 (11) [back to overview]Von Willebrand Factor Antigen
NCT02876601 (11) [back to overview]Clotting Time in Thromboelastometry
NCT02876601 (11) [back to overview]E-Selectin
NCT02876601 (11) [back to overview]Interleukin-6
NCT02876601 (11) [back to overview]Maximum Lysis in Thromboelastometry
NCT03339297 (26) [back to overview]Change From Baseline to Day +180 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Usual Activities Dimension for Participants With Age >=16 Years
NCT03339297 (26) [back to overview]Change From Baseline to Days +100 and +180 Post-HSCT in Participant Reported Outcomes as Measured Based on the EQ Visual Analog Scale (EQ VAS)
NCT03339297 (26) [back to overview]Change From Baseline to Days +100 and +180 Post-HSCT in Participant Reported Outcomes Measured Based on the EQ-5D-5L Index Value for Health States
NCT03339297 (26) [back to overview]Change From Baseline to Days +100 and +180 Post-HSCT in the Bone Marrow Transplantation Subscale (BMTS) as Measured by the FACT-BMT Questionnaire Score
NCT03339297 (26) [back to overview]Change From Baseline to Days +100 and +180 Post-HSCT in the Emotional Wellbeing Subscale as Measured by the FACT-BMT Questionnaire Score
NCT03339297 (26) [back to overview]Change From Baseline to Day +180 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Mobility Dimension for Participants With Age >=16 Years
NCT03339297 (26) [back to overview]Change From Baseline to Days +100 and +180 Post-HSCT in the FACT-BMT Total Score
NCT03339297 (26) [back to overview]Change From Baseline to Days +100 and +180 Post-HSCT in the Functional Assessment of Cancer Therapy-Bone Marrow Transplant-Trial Outcomes Index (FACT-BMT-TOI)
NCT03339297 (26) [back to overview]Change From Baseline to Day +100 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Usual Activities Dimension for Participants With Age >=16 Years
NCT03339297 (26) [back to overview]Change From Baseline to Days +100 and +180 Post-HSCT in the General (FACT-G) Questionnaire Score
NCT03339297 (26) [back to overview]Change From Baseline to Days +100 and +180 Post-HSCT in the Physical Wellbeing Subscale as Measured by the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) Questionnaire Score
NCT03339297 (26) [back to overview]Change From Baseline to Days +100 and +180 Post-HSCT in the Social/Family Wellbeing Subscale as Measured by the FACT-BMT Questionnaire Score
NCT03339297 (26) [back to overview]Cumulative Incidence Percentage of Disease Relapse by Days +100 and +180 Post-HSCT
NCT03339297 (26) [back to overview]Cumulative Incidence Percentage of Grade C to D aGvHD by Days +100 and +180 Post-HSCT
NCT03339297 (26) [back to overview]Cumulative Incidence Percentage of Grade B to D Acute Graft Versus Host Disease (aGvHD) by Day +100 Post-Hematopoietic Stem Cell Transplant (HSCT)
NCT03339297 (26) [back to overview]Cumulative Incidence Percentage of Grade B to D aGvHD by Day +180 Post-HSCT
NCT03339297 (26) [back to overview]Cumulative Incidence Percentage of Systemic Steroids for the Treatment of aGvHD +180 Days Post-HSCT
NCT03339297 (26) [back to overview]Change From Baseline to Day +100 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Anxiety/Depression Dimension for Participants With Age >=16 Years
NCT03339297 (26) [back to overview]Change From Baseline to Day +100 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Mobility Dimension for Participants With Age >=16 Years
NCT03339297 (26) [back to overview]Change From Baseline to Day +100 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Pain/Discomfort Dimension for Participants With Age >=16 Years
NCT03339297 (26) [back to overview]Change From Baseline to Day +100 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Self-Care Dimension for Participants With Age >=16 Years
NCT03339297 (26) [back to overview]Kaplan-Meier Estimate of Grade B to D aGvHD-free Survival by Days +100 and +180 Post-HSCT
NCT03339297 (26) [back to overview]Change From Baseline to Day +180 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Anxiety/Depression Dimension for Participants With Age >=16 Years
NCT03339297 (26) [back to overview]Change From Baseline to Days +100 and +180 Post-HSCT in the Functional Wellbeing Subscale as Measured by the FACT-BMT Questionnaire Score
NCT03339297 (26) [back to overview]Change From Baseline to Day +180 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Pain/Discomfort Dimension for Participants With Age >=16 Years
NCT03339297 (26) [back to overview]Change From Baseline to Day +180 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Self-Care Dimension for Participants With Age >=16 Years
NCT03384693 (7) [back to overview]Participants With Hypersensitivity Reaction Requiring Discontinuation of Therapy [Safety]
NCT03384693 (7) [back to overview]Number of Patients With Severe TMA
NCT03384693 (7) [back to overview]Number of Patients With TMA Enrolled on the Study
NCT03384693 (7) [back to overview]Participants With Clinically Significant Bleeding Requiring Discontinuation of Therapy [Safety]
NCT03384693 (7) [back to overview]Participants With Reportable Serious Adverse Events [Safety] Per CTACAE v5 Grade 3 or Higher
NCT03384693 (7) [back to overview]Percent of Total Doses of Defibrotide That Were Missed [Feasibility]
NCT03384693 (7) [back to overview]Incidence of TMA
NCT03954106 (6) [back to overview]Incidence of CAR-T-Associated Neurotoxicity Grade 3 or Greater Defined by CTCAE v5.0 by CAR-T Day +30
NCT03954106 (6) [back to overview]Incidence of CAR-T-Associated Neurotoxicity of Any Grade According to the ASBMT Consensus Grading System by CAR-T Day +30
NCT03954106 (6) [back to overview]Incidence of CAR-T-associated Neurotoxicity of Any Grade, Defined by CTCAE v5.0 by CAR-T Day +30
NCT03954106 (6) [back to overview]Incidence of CAR-T-Associated Neurotoxicity of Grade 3 or Greater According to the ASBMT Consensus Grading System by CAR-T Day +30
NCT03954106 (6) [back to overview]Use of High Dose Steroid By CAR-T Day +30
NCT03954106 (6) [back to overview]Incidence of Cytokine Release Syndrome (CRS) of Any Grade According to the ASBMT Consensus Grading System by CAR-T Day +30
NCT04530604 (7) [back to overview]Overall Survival
NCT04530604 (7) [back to overview]Overall Survival
NCT04530604 (7) [back to overview]Mean Change in the WHO COVID-19 Ordinal Scale During Therapy
NCT04530604 (7) [back to overview]Number of Major Hemorrhagic Complications Within 14 Days of Initiation of Treatment
NCT04530604 (7) [back to overview]Ventilator-free Survival
NCT04530604 (7) [back to overview]The Time to Improvement in Oxygenation
NCT04530604 (7) [back to overview]Number of Ventilator Free Days Within 14 Days of Study Entry

Complete Response by Day+100 Post Hematopoietic Stem Cell Transplant

The 95.1% CI instead of 95% CI is used for the final analysis to provide a small adjustment for the fact that an interim analysis was performed. (NCT00358501)
Timeframe: Day+100 post hematopoietic stem cell transplant

Interventionpercentage of participants (Number)
Defibrotide25.5
Historical Control12.5

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Survival at Day+100 Following Hematopoietic Stem Cell Transplant

The 95.1% CI instead of 95% CI is used for the final analysis to provide a small adjustment for the fact that an interim analysis was performed. (NCT00358501)
Timeframe: Day+100 post hematopoietic stem cell transplant

Interventionpercentage of participants (Number)
Defibrotide38.2
Historical Control25.0

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Percentage of Participants With Treatment-Emergent Adverse Events

(NCT00358501)
Timeframe: Through 30 days from the last dose of Defibrotide

,
Interventionpercentage of participants (Number)
Overall TEAEsTEAEs that led to deathTreatment-emergent hemorrhage event
Defibrotide976464
Historical Control1006975

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Survival at Day+180 Post Hematopoietic Stem Cell Transplantation

The 95.1% CI instead of 95% CI is used for the final analysis to provide a small adjustment for the fact that an interim analysis was performed. (NCT00358501)
Timeframe: 180 days post hematopoietic stem cell transplant

Interventionpercentage of participants (Number)
Defibrotide32.4
Historical Control25.0

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Historical Control Group Adverse Event Information

Historical Control group was not assessed for severity (NCT00358501)
Timeframe: Through 30 days from the last dose of Defibrotide

InterventionNumber of patients (Number)
Total Number of Participants AffectedCoagulopathyAnaemiaDisseminated intravascular coagulationThrombocytopeniaHaemorrhagic anaemiaTachycardiaBradycardiaCardiac arrestAtrial fibrillationCardiac failure congestiveSinus tachycardiaCardio-respiratory arrestVentricular tachycardiaAcute myocardial infarctionCardiac failureCardiac tamponadeDilatation ventricularPericarditis uraemicSupraventricular tachycardiaSystolic dysfunctionTachyarrhythmiaVentricular hypokinesiaAdrenal haemorrhageEuthyroid sick syndromeConjunctival haemorrhageOcular icterusScleral haemorrhageConjunctival hyperaemiaDry eyeEye dischargeEye haemorrhageEye irritationLid sulcus deepenedPupils unequalDiarrhoeaVomitingNauseaAbdominal painConstipationGastrointestinal haemorrhageHaematemesisLip haemorrhageMouth haemorrhageDyspepsiaHaematocheziaMelaenaRetchingAbdominal distensionChapped lipsGastrointestinal hypomotilityGastrointestinal sounds abnormalUpper gastrointestinal haemorrhageAbdominal discomfortAbdominal tendernessDuodenal perforationDuodenal ulcerDysphagiaEpigastric discomfortGastritisLip swellingLower gastrointestinal haemorrhageOesophagitisOral disorderPancreatitisUmbilical herniaPyrexiaMulti-organ failureOedema peripheralGeneralised oedemaHypothermiaOedemaPainFace oedemaAstheniaChillsCatheter site erythemaIrritabilityCatheter site swellingSystemic inflammatory response syndromeThrombosis in deviceCatheter site related reactionExtravasationPolyserositisVenoocclusive liver diseaseHepatic failureJaundiceHepatorenal syndromeAcute hepatic failureCholelithiasisGallbladder disorderHepatomegalyPortal vein thrombosisGraft versus host disease in skinGraft versus host diseaseGraft versus host disease in intestineGraft versus host disease in liverEngraftment syndromeHypogammaglobulinaemiaSepsisSeptic shockBacteraemiaCytomegalovirus infectionPneumoniaCandida sepsisCandidiasisEnterococcal infectionCatheter site infectionEnterococcal sepsisOral candidiasisSinusitisStaphylococcal bacteraemiaBacterial infectionClostridium difficile colitisHerpes simplexNasopharyngitisOsteomyelitis chronicPneumonia fungalStreptococcal bacteraemiaUrinary tract infection enterococcalVaginal infectionPost procedural haemorrhageContusionLacerationPeriorbital haemorrhageToxicity to various agentsPeriorbital contusionEndotracheal intubation complicationEscharEye contusionScratchWound haemorrhageWound secretionBlood urine presentHaematocrit decreasedHeart rate increasedActivated partial thromboplastin time prolongedAmmonia increasedBlood urea increasedBlood urineBreath sounds abnormalCardiac murmurHaemoglobin decreasedOccult blood positiveProthrombin time prolongedTransaminases increasedUrine output decreasedHyperglycaemiaFluid overloadMetabolic acidosisHypovolaemiaAcidosisDecreased appetiteHypercalcaemiaHypernatraemiaFluid retentionHypervolaemiaHypoalbuminaemiaLactic acidosisType 2 diabetes mellitusBack painMuscle spasmsMyalgiaGroin painLimb discomfortPain in extremityPain in jawConvulsionTremorCerebral haemorrhageSomnolenceAsterixisLethargyMental impairmentBrain oedemaParalysisIntercranial pressure increasedPeripheral nerve palsyAgitationConfusional stateAnxietyMental status changeInsomniaDepressionDisorientationParanoiaHaematuriaCystitis haemorrhagicRenal failureBladder spasmIncontinenceAnuriaAzotaemiaBladder outlet obstructionChromaturiaPollakiuriaUrinary retentionScrotal oedemaOedema genitalPerineal painVaginal haemorrhageVulvovaginal erythemaEpistaxisPulmonary alveolar haemorrhageRespiratory failurePleural effusionCoughRalesDyspnoeaTachypnoeaApnoeaAtelectasisNasal flaringOropharyngeal painAcute respiratory distress syndromeHaemothoraxPneumonia aspirationRespiratory distressSputum discolouredWheezingBronchial haemorrhageBronchial secretion retentionHaemoptysisHyperventilationIdiopathic pneumonia syndromePneumomediastinumPneumonitisPulmonary embolismRespiratory acidosisRespiratory disorderRespiratory tract oedemaUpper respiratory tract congestionUse of accessory respiratory musclesPetechiaeRashBlisterDecubitus ulcerErythemaPruritusSkin disorderAlopeciaRash erythematousEcchymosisSkin ulcerBlood blisterSkin exfoliationDermatitis bullousPurpuraRash macularGeneralised erythemaHyperhidrosisRash maculo-papularSkin discolourationSkin hypopigmentationSkin necrosisHypotensionCapillary leak syndromeIschaemiaPallorCirculatory collapseHypertensionHypovolaemic shockShock
Historical Control3251111146212111111111111113111111111128107533431321112111111111111111934857331212111111233211111522311223111111112111111111112122111111122111111111111454221111111131111113412111111195414141511321111112111155463652123111221111111111111119781335521212111111111162111111

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Survival by Day+100 Post Stem Cell Transplant or Chemotherapy

(NCT00628498)
Timeframe: Day +100 from HSCT or 100 days from start of chemotherapy

InterventionPercentage of participants alive (Number)
Defibrotide49.9

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Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 8 and ≤ 15 Years: Mobility

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-Y, self-report version, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedunknown
Best Supportive Care21041
Defibrotide Prophylaxis1931

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Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 8 and ≤ 15 Years: Pain

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-Y, self-report version, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Best Supportive Care5831
Defibrotide Prophylaxis01211

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Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 8 and ≤ 15 Years: Self-Care

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-Y, self-report version, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Best Supportive Care41021
Defibrotide Prophylaxis3821

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Maximum Plasma Concentration (Cmax) of Defibrotide Prophylaxis During the Prophylaxis Phase

Cmax is the maximum defibrotide plasma concentration, obtained directly from the observed data. Cmax is a summary statistic and it is not reported on an hourly basis. If veno-occlusive disease (VOD) occurs, the prophylaxis phase starts on the baseline date and ends on the day before the start date of rescue defibrotide. If VOD does not occur, the prophylaxis phase starts on the baseline date and ends on the date of study completion/early termination. (NCT02851407)
Timeframe: Day +1 and +7 Post-HSCT

Interventionμg/mL (Mean)
Day +1 Post-HSCTDay +7 Post-HSCT
Defibrotide Prophylaxis30.440

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Mean Clearance of Defibrotide Prophylaxis During the Prophylaxis Phase

Mean systemic clearance after intravenous dosing. Mean clearance is a summary statistic and it is not reported on an hourly basis. If veno-occlusive disease (VOD) occurs, the prophylaxis phase starts on the baseline date and ends on the day before the start date of rescue defibrotide. If VOD does not occur, the prophylaxis phase starts on the baseline date and ends on the date of study completion/early termination. (NCT02851407)
Timeframe: Day +1 and +7 Post-HSCT

InterventionL/h (Mean)
Day +1 Post-HSCT
Defibrotide Prophylaxis4.7

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Non-Relapse Mortality (NRM) for Defibrotide (DP) and Best Supportive Care (BSC) by Days +100 and +180 Post-Hematopoietic Stem Cell Transplant (HSCT)

NRM is defined as death that occurs after HSCT in participants who were noted as having malignant primary disease on the disease history electronic case report form (eCRF) and do not have primary disease relapse post-HSCT. (NCT02851407)
Timeframe: Days +100 and +180 Post-HSCT

,
InterventionKM Estimate % of non-relapse survival (Number)
Day +100 Post-HSCTDay +180 Post-HSCT
Best Supportive Care89.781.9
Defibrotide Prophylaxis80.477.9

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Number of Participants With Graft Failure During the Prophylaxis Phase and Rescue Phase

Graft failure is defined as participants that after hematopoietic stem cell transplant (HSCT) never reached an absolute neutrophil count >0.5 x 10^9/L that is maintained for three consecutive days or a platelet count >20 x 10^9/L without a platelet transfusion in the preceding seven days. If veno-occlusive disease (VOD) occurs, the prophylaxis phase starts on the baseline date and ends on the day before the start date of rescue defibrotide. If VOD does not occur, the prophylaxis phase starts on the baseline date and ends on the date of study completion/early termination. For the subset of participants who developed VOD and received rescue defibrotide, the rescue treatment phase begins on the start date of rescue defibrotide and ends on the date of study completion/early termination. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Prophylaxis PhaseRescue Phase
Best Supportive Care54
Defibrotide Prophylaxis44

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Percentage of Participants With Chronic Graft-Versus-Host-Disease (GvHD) by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)

The values shown are the number and percentages of participants who developed chronic GvHD by Day +180 post-HSCT in the prophylaxis phase and rescue phase. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Prophylaxis PhaseRescue Phase
Best Supportive Care121
Defibrotide Prophylaxis142

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Percentage of Participants With Grades 2, 3, and 4 Acute Graft-Versus-Host-Disease (GvHD) by Days +30, +100, and +180 Post-Hematopoietic Stem Cell Transplant (HSCT) in the Prophylaxis Phase

The number and percentage of participants with Grade 2-4 acute GvHD in the prophylaxis phase. Grade 2 is defined as Skin stage = 3, or Liver stage = 1, or GI stage = 1. Grade 3 is defined as Skin stage = 3, or Liver stage = 2-3, or GI stage = 2-4. Grade 4 is defined as a Skin stage = 4, or Liver stage = 4, or GI stage = 2-4. (NCT02851407)
Timeframe: Days +30, +100, and +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Day +30 Post-HSCTDay +100 Post-HSCTDay +180 Post-HSCT
Best Supportive Care132426
Defibrotide Prophylaxis132022

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Volume of Distribution of Defibrotide Prophylaxis During the Prophylaxis Phase

Mean volume of distribution following intravenous dosing. Mean volume of distribution is a summary statistic and it is not reported on an hourly basis.If veno-occlusive disease (VOD) occurs, the prophylaxis phase starts on the baseline date and ends on the day before the start date of rescue defibrotide. If VOD does not occur, the prophylaxis phase starts on the baseline date and ends on the date of study completion/early termination. (NCT02851407)
Timeframe: Day +1 and +7 Post-HSCT

InterventionL (Mean)
Day +1 Post-HSCTDay +7 Post-HSCT
Defibrotide Prophylaxis7.95.9

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Percentage of Participants With Veno-Occlusive Disease (VOD)-Associated Multi-Organ Dysfunction (MOD) by Days +30 and Days +100 Post-Hematopoietic Stem Cell Transplant (HSCT) in Patients Who Developed VOD

"VOD-associated MOD is defined for participants as occurring if the investigator answers Yes to the question Has the participant been diagnosed with VOD associated MOD? in the electronic case report form (eCRF). The values below are the number of participants who received the answer, Yes." (NCT02851407)
Timeframe: Days +30 and +100 Post-HSCT

,
InterventionParticipants (Count of Participants)
Day +30 Post-HSCTDay +100 Post-HSCT
Best Supportive Care810
Defibrotide Prophylaxis89

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Percentage of Participants With Veno-Occlusive Disease (VOD) After Day +30 Post-Hematopoietic Stem Cell Transplant (HSCT) up to Days +100 and +180 Post-HSCT

The values shown are the number and percentage of participants with VOD after day +30 post-HSCT and on or before Days +100 and +180 post-HSCT. The diagnosis of VOD through Day +100 post-HSCT was made by Endpoint Adjudication Committee (EPAC), and the diagnosis of VOD after Day +100 post-HSCT was based on investigator assessments. (NCT02851407)
Timeframe: Days +100 and +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Day +100 Post-HSCTDay +180 Post-HSCT
Best Supportive Care55
Defibrotide Prophylaxis66

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Area Under the Defibrotide Concentration-Time Curve (AUClast) of Defibrotide Prophylaxis During the Rescue Phase

"AUClast is the area under the defibrotide concentration-time curve from 0 (pre-dose) to time of last quantifiable defibrotide concentration at time t. AUClast is a summary statistic and it is not reported on an hourly basis. For the subset of participants who developed veno-occlusive disease (VOD) and received rescue defibrotide, the rescue treatment phase begins on the start date of rescue defibrotide and ends on the date of study completion/early termination." (NCT02851407)
Timeframe: Day +14 Post-VOD Treatment

Interventionh*μg/mL (Mean)
Defibrotide Prophylaxis119.1
Best Supportive Care90.7

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Maximum Plasma Concentration (Cmax) of Defibrotide Prophylaxis During the Rescue Phase

Cmax is the maximum defibrotide plasma concentration, obtained directly from the observed data. Cmax is a summary statistic and it is not reported on an hourly basis. For the subset of participants who developed veno-occlusive disease (VOD) and received rescue defibrotide, the rescue treatment phase begins on the start date of rescue defibrotide and ends on the date of study completion/early termination. (NCT02851407)
Timeframe: Day +14 Post-VOD Treatment

Interventionμg/mL (Mean)
Defibrotide Prophylaxis44.4
Best Supportive Care39.7

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Number of Participants With Neutrophil Engraftment by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)

"The date of neutrophil engraftment was recorded on the electronic case report form (eCRF) and is defined as the first date after HSCT of an absolute neutrophil count >0.5 x 10^9/L that is maintained for three consecutive days. The definition of absolute neutrophil count includes both segmented neutrophils and bands, immature neutrophils. The number of participants with neutrophil engraftment was assessed." (NCT02851407)
Timeframe: Day +180 Post-HSCT

InterventionParticipants (Count of Participants)
Defibrotide Prophylaxis156
Best Supportive Care162

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Number of Participants With Platelet Engraftment by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)

The date of platelet engraftment was recorded on the electronic case report form (eCRF) and is defined as the first date after HSCT of a platelet count >20 x 10^9/L without a platelet transfusion in the preceding seven days. The number of participants with platelet engraftment was assessed. (NCT02851407)
Timeframe: Day +180 Post-HSCT

InterventionParticipants (Count of Participants)
Defibrotide Prophylaxis154
Best Supportive Care163

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Percentage of Participants Who Had Resolution of Veno-Occlusive Disease (VOD) by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)

The proportion of participants who had resolution of VOD by Day +180 post-HSCT is reported as a percentage. (NCT02851407)
Timeframe: Day +180 Post-HSCT

InterventionParticipants (Count of Participants)
Defibrotide Prophylaxis6
Best Supportive Care15

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Percentage of Participants With Veno-Occlusive Disease (VOD) by Day +30 Post-Hematopoietic Stem Cell Transplant (HSCT)

The number of participants who were diagnosed with VOD based on the Modified Seattle Criteria as per blinded EPAC assessment. The percentage was calculated out of the total number of participants in each arm of the study. The values reported below are the numbers and percentages of participants who experienced VOD by Day +30 post-HSCT. (NCT02851407)
Timeframe: Day +30 Post-HSCT

InterventionParticipants (Count of Participants)
Defibrotide Prophylaxis47
Best Supportive Care38

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Percentage of Participants With Grades 2, 3, and 4 Acute Graft-Versus-Host-Disease (GvHD) by Days +30, +100, and +180 Post-Hematopoietic Stem Cell Transplant (HSCT) in the Rescue Phase

The number and percentage of participants with Grade 2-4 acute GvHD in the rescue phase. Grade 2 is defined as Skin stage = 3, or Liver stage = 1, or GI stage = 1. Grade 3 is defined as Skin stage = 3, or Liver stage = 2-3, or GI stage = 2-4. Grade 4 is defined as a Skin stage = 4, or Liver stage = 4, or GI stage = 2-4. (NCT02851407)
Timeframe: Days +30, +100, and +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Day +30 Post-HSCTDay +100 Post-HSCTDay +180 Post-HSCT
Best Supportive Care111
Defibrotide Prophylaxis566

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Veno-Occlusive Disease (VOD)-Free Survival by Day +100 Post-Hematopoietic Stem Cell Transplant (HSCT) Per the Independent Endpoint Adjudication Committee (EPAC)

VOD-free survival is a composite of survival status and VOD occurrence as determined by modified Seattle criteria adjudicated by a blinded independent EPAC. An event is defined as a VOD diagnosis (as assessed by the EPAC) or death, whichever, is earlier, up to and including Day +100 post-HSCT. The values reported below are participants who did not experience VOD or death by Day +100 post-HSCT. (NCT02851407)
Timeframe: Day +100 Post-HSCT

InterventionKM Estimate % of participants (Number)
Defibrotide Prophylaxis49.8
Best Supportive Care57.1

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Veno-occlusive Disease (VOD)-Free Survival by Day +30 Post-Hematopoietic Stem Cell Transplant (HSCT) Per the Independent Endpoint Adjudication Committee (EPAC)

VOD-free survival is a composite of survival status and VOD occurrence as determined by modified Seattle criteria adjudicated by a blinded independent EPAC. An event is defined as a VOD diagnosis (as assessed by the EPAC) or death, whichever, is earlier, up to and including Day +30 post-HSCT. The values reported below are participants who did not experience VOD or death by Day +30 post-HSCT. (NCT02851407)
Timeframe: Day +30 Post-HSCT

InterventionKM Estimate % of participants (Number)
Defibrotide Prophylaxis66.8
Best Supportive Care72.5

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Veno-Occlusive Disease (VOD)-Free Survival Rate by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)

VOD-free survival is a composite of survival status and VOD occurrence as determined by modified Seattle criteria. An event is defined as a VOD diagnosis or death, whichever, is earlier, up to and including Day +180 post-HSCT. The diagnosis of VOD through Day +100 post-HSCT was based on Endpoint Adjudication Committee (EPAC), and the diagnosis of VOD after Day +100 post-HSCT was based on investigator assessments. The values reported below are participants who did not experience VOD or death by Day +180 post-HSCT. (NCT02851407)
Timeframe: Day +180 Post-HSCT

InterventionKM Estimate % of participants (Number)
Defibrotide Prophylaxis34.6
Best Supportive Care42.8

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Volume of Distribution of Defibrotide Prophylaxis During the Rescue Phase

Mean volume of distribution following intravenous dosing. Mean volume of distribution is a summary statistic and it is not reported on an hourly basis. For the subset of participants who developed veno-occlusive disease (VOD) and received rescue defibrotide, the rescue treatment phase begins on the start date of rescue defibrotide and ends on the date of study completion/early termination. (NCT02851407)
Timeframe: Day +14 Post-VOD Treatment

InterventionL (Mean)
Defibrotide Prophylaxis6.3
Best Supportive Care6.7

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Area Under the Defibrotide Concentration-Time Curve (AUClast) of Defibrotide Prophylaxis During the Prophylaxis Phase

"AUClast is the area under the defibrotide concentration-time curve from 0 (pre-dose) to time of last quantifiable defibrotide concentration at time t. AUClast is a summary statistic and it is not reported on an hourly basis. If veno-occlusive disease (VOD) occurs, the prophylaxis phase starts on the baseline date and ends on the day before the start date of rescue defibrotide. If VOD does not occur, the prophylaxis phase starts on the baseline date and ends on the date of study completion/early termination." (NCT02851407)
Timeframe: Day +1 and +7 Post-HSCT

Interventionh*μg/mL (Mean)
Day +1 Post-HSCTDay +7 Post-HSCT
Defibrotide Prophylaxis61.678.2

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Change in 5-Level EuroQol-5D (EQ-5D-5L) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Adult Participants Age ≥ 16 Years: Activity

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-5L, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 Post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchagedCondition deterioratedUnknown
Best Supportive Care1022104
Defibrotide Prophylaxis72495

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Change in 5-Level EuroQol-5D (EQ-5D-5L) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Adult Participants Age ≥ 16 Years: Anxiety

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-5L, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 Post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchagedCondition deterioratedUnknown
Best Supportive Care112744
Defibrotide Prophylaxis112275

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Time to Resolution of Veno-Occlusive Disease (VOD) by Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT)

Time to Resolution of VOD is calculated as follows: Time to Resolution of VOD= [Date of VOD resolution] - [Date of VOD diagnosis by investigator]. (NCT02851407)
Timeframe: Day +180 Post-HSCT

InterventionDays (Median)
Defibrotide ProphylaxisNA
Best Supportive Care30.0

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Change in 5-Level EuroQol-5D (EQ-5D-5L) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Adult Participants Age ≥ 16 Years: Pain

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-5L, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 Post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchagedCondition deterioratedUnknown
Best Supportive Care1119124
Defibrotide Prophylaxis102564

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Change in 5-Level EuroQol-5D (EQ-5D-5L) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Adult Participants Age ≥ 16 Years: Self-Care

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-5L, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 Post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchagedCondition deterioratedUnknown
Best Supportive Care63244
Defibrotide Prophylaxis33534

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Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 4 and ≤ 7 Years: Activity

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-Y, self-report version, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Best Supportive Care11112
Defibrotide Prophylaxis2742

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Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 4 and ≤ 7 Years: Anxiety

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-Y, self-report version, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Best Supportive Care21012
Defibrotide Prophylaxis3822

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Change in 5-Level EuroQol-5D (EQ-5D-5L) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Adult Participants Age ≥ 16 Years: Mobility

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-5L, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 Post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchagedCondition deterioratedUnknown
Best Supportive Care72865
Defibrotide Prophylaxis42894

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Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 4 and ≤ 7 Years: Pain

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-Y, self-report version, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Best Supportive Care3912
Defibrotide Prophylaxis4722

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Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 4 and ≤ 7 Years: Self-Care

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-Y, self-report version, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Best Supportive Care21012
Defibrotide Prophylaxis3732

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Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 8 and ≤ 15 Years: Activity

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-Y, self-report version, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Best Supportive Care31031
Defibrotide Prophylaxis1751

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Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 8 and ≤ 15 Years: Anxiety

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-Y, self-report version, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Best Supportive Care6821
Defibrotide Prophylaxis6521

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Change in EuroQol-5D for Youth (EQ-5D-Y) Dimensions From Baseline to Day +180 Post-Hematopoietic Stem Cell Transplant (HSCT) for Pediatric Participants Age ≥ 4 and ≤ 7 Years: Mobility

For each of the five dimensions of mobility, self-care, activity, pain, and anxiety based on the descriptive system of the EQ-5D-Y, self-report version, the numbers and percentages of participants for all categories (the three levels of reported problems and question not completed) at Day +180 post-HSCT was assessed. Each dimension was categorized as follows: Condition improved, if the reported level of problem is lower at the assessment than baseline; condition unchanged, if the reported level of problem remains the same; condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; and unknown, if the reported level of problem is missing either at baseline or at that assessment. (NCT02851407)
Timeframe: Day +180 Post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Best Supportive Care1842
Defibrotide Prophylaxis2832

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Plasmin-Antiplasmin Complexes

"Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold*h.~The placebo period (4 subjects who did not receive lipopolysaccharide) was only included for a descriptive comparison, but not for statistical comparison" (NCT02876601)
Timeframe: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, and 6h and AUC was calculated based on these measurements.

Interventionfold*h (Median)
LPS Plus Defibrotide11.8
LPS/Placebo9.99
Placebo Plus Defibrotide7
Placebo Plus Placebo7.12

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Plasminogen Activator Inhibitor 1

"Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject.~The respective arbitrary unit therefore is fold*h." (NCT02876601)
Timeframe: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.

Interventionfold*h (Median)
LPS Plus Defibrotide216
LPS Plus Placebo477
Placebo Plus Defibrotide25
Placebo Plus Placebo24.86

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Prothrombin Fragments f1+2

"Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold*h.~The placebo period (4 subjects who did not receive lipopolysaccharide) was only included for a descriptive comparison, but not for statistical comparison" (NCT02876601)
Timeframe: The parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h.

Interventionfold-change*h (Median)
LPS Plus Defibrotide31.1
LPS Plus Placebo34.08
Placebo Plus Defibrotide27.41
Placebo Plus Placebo36.02

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Thrombin-Antithrombin Complexes

"Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold*h.~The placebo period (4 subjects who did not receive lipopolysaccharide) was only included for a descriptive comparison, but not for statistical comparison" (NCT02876601)
Timeframe: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.

Interventionfold*h (Median)
LPS Plus Defibrotide23.39
LPS Plus Placebo27.4
Placebo Plus Defibrotide17.46
Placebo Plus Placebo21.83

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Tissue-type Plasminogen Activator

"Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject.~The respective arbitrary unit therefore is fold*h." (NCT02876601)
Timeframe: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.

Interventionfold*h (Median)
LPS Plus Defibrotide21.8
LPS Plus Placebo17
Placebo Plus Defibrotide20.57
Placebo Plus Placebo23.54

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Tumor Necrosis Factor (TNF)-Alpha

"Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject.~The respective arbitrary unit therefore is fold*h." (NCT02876601)
Timeframe: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.

Interventionfold*h (Median)
LPS Plus Defibrotide286
LPS Plus Placebo326
Placebo Plus Defibrotide28.08
Placebo Plus Placebo21.01

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Von Willebrand Factor Antigen

"Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The quantification of von Willebrand Factor is based on reference values and results are in % of normal.~The respective arbitrary unit therefore is %*h." (NCT02876601)
Timeframe: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.

Intervention%*h (Median)
LPS Plus Defibrotide54
LPS Plus Placebo53
Placebo Plus Defibrotie27
Placebo Plus Placebo26

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Clotting Time in Thromboelastometry

"In this analysis, first of all a ratio of the measurement time point to the baseline was calculated. Thereafter deltas (baeline-ratio) were calculated. With the results an AUC was calculated.~The respective arbitrary unit therefore is fold*h." (NCT02876601)
Timeframe: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.

Interventionfold*h (Median)
LPS Plus Defibrotide1.12
LPS Plus Placebo1.12
Placebo Plus Defibrotide-0.2
Placebo Plus Placebo2.14

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E-Selectin

"Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject.~The respective arbitrary unit therefore is fold*h." (NCT02876601)
Timeframe: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.

Interventionfold*h (Median)
LPS Plus Defibrotide35
LPS Plus Placebo33
Placebo Plus Defibrotide21
Placebo Plus Placebo41

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Interleukin-6

Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold*h. (NCT02876601)
Timeframe: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.

Interventionfold*h (Median)
LPS Plus Defibrotide1543
LPS Plus Placebo1144
Placebo Plus Defibrotide35
Placebo Plus Placebo31

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Maximum Lysis in Thromboelastometry

"Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject.~The respective arbitrary unit therefore is fold*h." (NCT02876601)
Timeframe: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h and AUC was calculated based on these measurements.

Interventionfold*h (Median)
LPS Plus Defibrotide7.9
LPS Plus Placebo7.7
Placebo Plus Defibrotide6.84
Placebo Plus Placebo6.85

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Change From Baseline to Day +180 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Usual Activities Dimension for Participants With Age >=16 Years

The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). For each of the 5 dimensions based on the descriptive system of the EQ-5D-5L, the numbers of participants for all categories (the 5 levels of reported problems) were assessed. For Day +180 Post-HSCT change between baseline in each dimension will be categorized as follows for a specific participant: Condition improved, if the reported level of problem is lower at that assessment than at baseline; Condition unchanged, if the reported level of problem remains the same; Condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; Unknown, if the reported level of problem is not completed or missing either at baseline or at that assessment. (NCT03339297)
Timeframe: Baseline through Day +180 post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Defibrotide Prophylaxis10161417
Standard of Care Immunoprophylaxis5191819

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Change From Baseline to Days +100 and +180 Post-HSCT in Participant Reported Outcomes as Measured Based on the EQ Visual Analog Scale (EQ VAS)

The EQ VAS score at baseline and each of the post-HSCT assessments was summarized and presented using descriptive statistics. A higher EQ VAS score represents better QoL. For each of the post-HSCT assessments, change between baseline and that assessment in the EQ VAS score was calculated similarly to the EQ-5D-5L index value for a specific participant and was summarized and presented using descriptive statistics. The score ranges from a minimum of 0 and a maximum of 100. A negative change in the score indicates a decrease in quality of life. (NCT03339297)
Timeframe: Baseline through Days +100 and +180 post-HSCT

,
Interventionunit on a scale (Mean)
Change from Baseline to Day +100 post-HSCTChange from Baseline to Day +180 post-HSCT
Defibrotide Prophylaxis6.032.24
Standard of Care Immunoprophylaxis2.70-0.90

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Change From Baseline to Days +100 and +180 Post-HSCT in Participant Reported Outcomes Measured Based on the EQ-5D-5L Index Value for Health States

The 5-Level EuroQol-5D health questionnaire (EQ-5D-5L) index value, which is country-specific, was only performed for participants in the US. The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). Change from the baseline assessment to Days +100 and +180 post-HSCT in the index value was assessed. The index value total range is from a minimum value of -1 to a maximum value of +1. A higher EQ-5D-5L index value represents better quality of life (QoL), thus a positive change in the index value represents improved QoL. (NCT03339297)
Timeframe: Baseline through Days +100 and +180 post-HSCT

,
Interventionunit on a scale (Mean)
Change from Baseline to Day +100 post-HSCTChange from Baseline to Day +180 post-HSCT
Defibrotide Prophylaxis0.020.02
Standard of Care Immunoprophylaxis-0.01-0.01

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Change From Baseline to Days +100 and +180 Post-HSCT in the Bone Marrow Transplantation Subscale (BMTS) as Measured by the FACT-BMT Questionnaire Score

The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) total score is the sum of the FACT physical wellbeing score, the FACT social/family wellbeing score, the FACT emotional wellbeing score, the FACT functional wellbeing score, and the FACT-BMT subscale. The FACT-BMT subscale scores range from a minimum of 0 to a maximum of 40, with higher scores indicating better quality of life. A negative change from baseline indicates a decrease in score. (NCT03339297)
Timeframe: Baseline through Days +100 and +180 post-HSCT

,
Interventionunit on a scale (Mean)
Change from Baseline to Day +100 post-HSCTChange from Baseline to Day +180 post-HSCT
Defibrotide Prophylaxis-0.88-2.33
Standard of Care Immunoprophylaxis-2.14-1.01

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Change From Baseline to Days +100 and +180 Post-HSCT in the Emotional Wellbeing Subscale as Measured by the FACT-BMT Questionnaire Score

The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) total score is the sum of the FACT physical wellbeing score, the FACT social/family wellbeing score, the FACT emotional wellbeing score, the FACT functional wellbeing score, and the FACT-BMT subscale. The FACT emotional wellbeing subscale scores range from a minimum of 0 to a maximum of 24, with higher scores indicating better quality of life. (NCT03339297)
Timeframe: Baseline through Days +100 and +180 post-HSCT

,
Interventionunit on a scale (Mean)
Change from Baseline to Day +100 post-HSCTChange from Baseline to Day +180 post-HSCT
Defibrotide Prophylaxis1.470.79
Standard of Care Immunoprophylaxis1.471.53

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Change From Baseline to Day +180 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Mobility Dimension for Participants With Age >=16 Years

The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). For each of the 5 dimensions based on the descriptive system of the EQ-5D-5L, the numbers of participants for all categories (the 5 levels of reported problems) were assessed. For Day +180 Post-HSCT change between baseline in each dimension will be categorized as follows for a specific participant: Condition improved, if the reported level of problem is lower at that assessment than at baseline; Condition unchanged, if the reported level of problem remains the same; Condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; Unknown, if the reported level of problem is not completed or missing either at baseline or at that assessment. (NCT03339297)
Timeframe: Baseline through Day +180 post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Defibrotide Prophylaxis3261117
Standard of Care Immunoprophylaxis3251419

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Change From Baseline to Days +100 and +180 Post-HSCT in the FACT-BMT Total Score

The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) total score is the sum of the FACT physical wellbeing score, the FACT social/family wellbeing score, the FACT emotional wellbeing score, the FACT functional wellbeing score, and the FACT-BMT subscale. The FACT-BMT total score range is from a minimum of 0 to a maximum of 148, with higher scores indicating better quality of life. A negative change from baseline indicates a decrease in score. (NCT03339297)
Timeframe: Baseline through Days +100 and +180 post-HSCT

,
Interventionunit on a scale (Mean)
Change from Baseline to Day +100 post-HSCTChange from Baseline to Day +180 post-HSCT
Defibrotide Prophylaxis-3.24-6.38
Standard of Care Immunoprophylaxis-3.70-2.83

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Change From Baseline to Days +100 and +180 Post-HSCT in the Functional Assessment of Cancer Therapy-Bone Marrow Transplant-Trial Outcomes Index (FACT-BMT-TOI)

The FACT-BMT-TOI is defined as the sum of the FACT physical wellbeing score, the FACT functional wellbeing score, and the FACT-BMT subscale. Scores range from a minimum of 0 to a maximum of 96, with higher scores indicating better quality of life. A negative change from baseline indicates a decrease in score. (NCT03339297)
Timeframe: Baseline through Days +100 and +180 post-HSCT

,
Interventionunit on a scale (Mean)
Change from Baseline to Day +100 post-HSCTChange from Baseline to Day +180 post-HSCT
Defibrotide Prophylaxis-3.88-6.99
Standard of Care Immunoprophylaxis-5.24-3.33

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Change From Baseline to Day +100 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Usual Activities Dimension for Participants With Age >=16 Years

The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). For each of the 5 dimensions based on the descriptive system of the EQ-5D-5L, the numbers of participants for all categories (the 5 levels of reported problems) were assessed. For Day +100 Post-HSCT change between baseline in each dimension will be categorized as follows for a specific participant: Condition improved, if the reported level of problem is lower at that assessment than at baseline; Condition unchanged, if the reported level of problem remains the same; Condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; Unknown, if the reported level of problem is not completed or missing either at baseline or at that assessment. (NCT03339297)
Timeframe: Baseline through Day +100 post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Defibrotide Prophylaxis8211319
Standard of Care Immunoprophylaxis7221815

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Change From Baseline to Days +100 and +180 Post-HSCT in the General (FACT-G) Questionnaire Score

The FACT-General (FACT-G) is a core component of the FACT-BMT, and includes 4 of the 5 subscales included in the FACT-BMT total score (FACT physical wellbeing score, FACT social/family wellbeing score, FACT emotional wellbeing score, the FACT functional wellbeing score). In line with this similarity, results of the FACT-G exhibited the same pattern as described for the FACT-BMT total score. The FACT-G scores range from a minimParticipants were age ≥16 years at baseline. (NCT03339297)
Timeframe: Baseline through Days +100 and +180 post-HSCT

,
Interventionunit on a scale (Mean)
Change from Baseline to Day +100 post-HSCTChange from Baseline to Day +180 post-HSCT
Defibrotide Prophylaxis-2.38-4.03
Standard of Care Immunoprophylaxis-1.74-1.33

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Change From Baseline to Days +100 and +180 Post-HSCT in the Physical Wellbeing Subscale as Measured by the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) Questionnaire Score

The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) total score is the sum of the FACT physical wellbeing score, the FACT social/family wellbeing score, the FACT emotional wellbeing score, the FACT functional wellbeing score, and the FACT-BMT subscale. The FACT physical wellbeing subscale scores range from a minimum of 0 to a maximum of 28, with higher scores indicating better quality of life. A negative change from baseline indicates a decrease in score. (NCT03339297)
Timeframe: Baseline through Days +100 and +180 post-HSCT

,
Interventionunit on a scale (Mean)
Change from Baseline to Day +100 post-HSCTChange from Baseline to Day +180 post-HSCT
Defibrotide Prophylaxis-1.25-1.55
Standard of Care Immunoprohylaxis-1.41-1.54

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Change From Baseline to Days +100 and +180 Post-HSCT in the Social/Family Wellbeing Subscale as Measured by the FACT-BMT Questionnaire Score

The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) total score is the sum of the FACT physical wellbeing score, the FACT social/family wellbeing score, the FACT emotional wellbeing score, the FACT functional wellbeing score, and the FACT-BMT subscale. The FACT social/family wellbeing subscale scores range from a minimum of 0 to a maximum of 28, with higher scores indicating better quality of life. A negative change from baseline indicates a decrease in score. (NCT03339297)
Timeframe: Baseline through Days +100 and +180 post-HSCT

,
Interventionunit on a scale (Mean)
Change from Baseline to Day +100 post-HSCTChange from Baseline to Day +180 post-HSCT
Defibrotide Prophylaxis-0.56-0.78
Standard of Care Immunoprophylaxis-0.29-1.34

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Cumulative Incidence Percentage of Disease Relapse by Days +100 and +180 Post-HSCT

Disease relapse was defined by either morphological evidence of acute leukemia or Myelodysplastic syndrome (MDS) consistent with pre-transplant features, documented or not by biopsy. The event was defined as an increase in size of prior sites of disease or evidence of new sites of disease, documented or not by biopsy. Disease relapse was diagnosed when there was morphological or clinical evidence of the following: reappearance of leukemia blast cells in the peripheral blood, or >5% blasts in the bone marrow (BM), not attributable to another cause (eg, BM regeneration), or the appearance of previous or new dysplastic changes (MDS specific) within the BM, with or without falling donor chimerism, or the development of extramedullary leukemia or leukemic cells in the cerebral spinal fluid, or institution of therapy to treat relapsed disease, including donor lymphocyte infusion. (NCT03339297)
Timeframe: HSCT Day (Day +0 post-HSCT) through Days +100 and +180 post-HSCT

,
Interventioncumulative incidence percentage (Number)
Day +100 post-HSCTDay +180 post-HSCT
Defibrotide Prophylaxis11.016.8
Standard of Care Immunoprophylaxis4.35.8

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Cumulative Incidence Percentage of Grade C to D aGvHD by Days +100 and +180 Post-HSCT

Cumulative Incidence Percentage of Grade C to D aGvHD was defined using the IBMTR Severity Index. Grade C is defined as Skin stage = 3 or Liver stage = 3 or GI stage = 3. Grade D is defined as a Skin stage = 4 or Liver stage = 4 or GI stage = 4. (NCT03339297)
Timeframe: HSCT Day (Day +0 post-HSCT) through Days +100 and +180 post-HSCT

,
Interventioncumulative incidence percentage (Number)
Day +100 post-HSCTDay +180 post-HSCT
Defibrotide Prophylaxis16.522.7
Standard of Care Immunoprophylaxis21.525.9

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Cumulative Incidence Percentage of Grade B to D Acute Graft Versus Host Disease (aGvHD) by Day +100 Post-Hematopoietic Stem Cell Transplant (HSCT)

Cumulative Incidence Percentage of Grade B to D aGvHD was defined using the International Bone Marrow Transplant Registry (IBMTR) Severity Index. Grade B is defined as Skin stage = 2 or Liver stage = 1 to 2 or GI stage = 1 to 2. Grade C is defined as Skin stage = 3 or Liver stage = 3 or GI stage = 3. Grade D is defined as a Skin stage = 4 or Liver stage = 4 or GI stage = 4. (NCT03339297)
Timeframe: HSCT Day (Day +0 post-HSCT) through Day +100 post-HSCT

Interventioncumulative incidence percentage (Number)
Defibrotide Prophylaxis38.4
Standard of Care Immunoprophylaxis47.1

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Cumulative Incidence Percentage of Grade B to D aGvHD by Day +180 Post-HSCT

Cumulative Incidence Percentage of Grade B to D aGvHD was defined using the IBMTR Severity Index. Grade B is defined as Skin stage = 2 or Liver stage = 1 to 2 or GI stage = 1 to 2. Grade C is defined as Skin stage = 3 or Liver stage = 3 or GI stage = 3. Grade D is defined as a Skin stage = 4 or Liver stage = 4 or GI stage = 4. (NCT03339297)
Timeframe: HSCT Day (Day +0 post-HSCT) through Day +180 post-HSCT

Interventioncumulative incidence percentage (Number)
Defibrotide Prophylaxis50.6
Standard of Care Immunoprophylaxis51.6

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Cumulative Incidence Percentage of Systemic Steroids for the Treatment of aGvHD +180 Days Post-HSCT

For each treatment arm, the cumulative incidence rate of systemic steroid use for the treatment of aGvHD by Day +180 post-HSCT will be estimated using the cumulative incidence competing risk estimator. The calculation of the cumulative incidence rates and the stratified Gray's test was carried out using the LIFETEST procedure in SAS version 9.4. If the participant experienced a competing risk event, then the initiation date was used to calculate the time-to-event variable. (NCT03339297)
Timeframe: HSCT Day (Day +0 post-HSCT) through Day +180 post-HSCT

Interventioncumulative incidence percentage (Number)
Defibrotide Prophylaxis38.2
Standard of Care Immunoprophylaxis28.6

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Change From Baseline to Day +100 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Anxiety/Depression Dimension for Participants With Age >=16 Years

The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). For each of the 5 dimensions based on the descriptive system of the EQ-5D-5L, the numbers of participants for all categories (the 5 levels of reported problems) were assessed. For Day +100 Post-HSCT change between baseline in each dimension will be categorized as follows for a specific participant: Condition improved, if the reported level of problem is lower at that assessment than at baseline; Condition unchanged, if the reported level of problem remains the same; Condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; Unknown, if the reported level of problem is not completed or missing either at baseline or at that assessment. (NCT03339297)
Timeframe: Baseline through Day +100 post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Defibrotide Prophylaxis727819
Standard of Care Immunoprophylaxis1030715

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Change From Baseline to Day +100 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Mobility Dimension for Participants With Age >=16 Years

The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). For each of the 5 dimensions based on the descriptive system of the EQ-5D-5L, the numbers of participants for all categories (the 5 levels of reported problems) were assessed. For Day +100 Post-HSCT change between baseline in each dimension will be categorized as follows for a specific participant: Condition improved, if the reported level of problem is lower at that assessment than at baseline; Condition unchanged, if the reported level of problem remains the same; Condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; Unknown, if the reported level of problem is not completed or missing either at baseline or at that assessment. (NCT03339297)
Timeframe: Baseline through Day +100 post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Defibrotide Prophylaxis331819
Standard of Care Immunoprophylaxis4281515

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Change From Baseline to Day +100 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Pain/Discomfort Dimension for Participants With Age >=16 Years

The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). For each of the 5 dimensions based on the descriptive system of the EQ-5D-5L, the numbers of participants for all categories (the 5 levels of reported problems) were assessed. For Days +100 Post-HSCT change between baseline in each dimension will be categorized as follows for a specific participant: Condition improved, if the reported level of problem is lower at that assessment than at baseline; Condition unchanged, if the reported level of problem remains the same; Condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; Unknown, if the reported level of problem is not completed or missing either at baseline or at that assessment. (NCT03339297)
Timeframe: Baseline through Day +100 post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Defibrotide Prophylaxis10181419
Standard of Care Immunoprophylaxis9201815

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Change From Baseline to Day +100 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Self-Care Dimension for Participants With Age >=16 Years

The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). For each of the 5 dimensions based on the descriptive system of the EQ-5D-5L, the numbers of participants for all categories (the 5 levels of reported problems) were assessed. For Day +100 Post-HSCT change between baseline in each dimension will be categorized as follows for a specific participant: Condition improved, if the reported level of problem is lower at that assessment than at baseline; Condition unchanged, if the reported level of problem remains the same; Condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; Unknown, if the reported level of problem is not completed or missing either at baseline or at that assessment. (NCT03339297)
Timeframe: Baseline through Day +100 post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Defibrotide Prophylaxis134719
Standard of Care Immunoprophylaxis0371015

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Kaplan-Meier Estimate of Grade B to D aGvHD-free Survival by Days +100 and +180 Post-HSCT

Grade B to D aGvHD was defined using the IBMTR Severity Index. Grade B is defined as Skin stage = 2 or Liver stage = 1 to 2 or GI stage = 1 to 2. Grade C is defined as Skin stage = 3 or Liver stage = 3 or GI stage = 3. Grade D is defined as a Skin stage = 4 or Liver stage = 4 or GI stage = 4. (NCT03339297)
Timeframe: HSCT Day (Day +0 post-HSCT) through Days +100 and +180 post-HSCT

,
Interventionpercentage of participants (Number)
Day +100 post-HSCTDay +180 post-HSCT
Defibrotide Prophylaxis60.345.1
Standard of Care Immunoprophylaxis51.442.6

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Change From Baseline to Day +180 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Anxiety/Depression Dimension for Participants With Age >=16 Years

The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). For each of the 5 dimensions based on the descriptive system of the EQ-5D-5L, the numbers of participants for all categories (the 5 levels of reported problems) were assessed. For Day +180 Post-HSCT change between baseline in each dimension will be categorized as follows for a specific participant: Condition improved, if the reported level of problem is lower at that assessment than at baseline; Condition unchanged, if the reported level of problem remains the same; Condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; Unknown, if the reported level of problem is not completed or missing either at baseline or at that assessment. (NCT03339297)
Timeframe: Baseline through Day +180 post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Defibrotide Prophylaxis8211117
Standard of Care Immunoprophylaxis1223620

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Change From Baseline to Days +100 and +180 Post-HSCT in the Functional Wellbeing Subscale as Measured by the FACT-BMT Questionnaire Score

The Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) total score is the sum of the FACT physical wellbeing score, the FACT social/family wellbeing score, the FACT emotional wellbeing score, the FACT functional wellbeing score, and the FACT-BMT subscale. The FACT functional wellbeing subscale scores range from a minimum of 0 to a maximum of 28, with higher scores indicating better quality of life. A negative change from baseline indicates a decrease in score. (NCT03339297)
Timeframe: Baseline through Days +100 and +180 post HSCT

,
Interventionunit on a scale (Mean)
Change from Baseline to Day +100 post-HSCTChange from Baseline to Day +180 post-HSCT
Defibrotide Prophylaxis-1.71-2.21
Standard of Care Immunoprophylaxis-2.11-0.95

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Change From Baseline to Day +180 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Pain/Discomfort Dimension for Participants With Age >=16 Years

The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). For each of the 5 dimensions based on the descriptive system of the EQ-5D-5L, the numbers of participants for all categories (the 5 levels of reported problems) were assessed. For Day +180 Post-HSCT change between baseline in each dimension will be categorized as follows for a specific participant: Condition improved, if the reported level of problem is lower at that assessment than at baseline; Condition unchanged, if the reported level of problem remains the same; Condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; Unknown, if the reported level of problem is not completed or missing either at baseline or at that assessment. (NCT03339297)
Timeframe: Baseline through Day +180 post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Defibrotide Prophylaxis6231117
Standard of Care Immunoprophylaxis8201419

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Change From Baseline to Day +180 Post-HSCT in 5-Level European Quality of Life (EQ-5D-5L) Self-Care Dimension for Participants With Age >=16 Years

The EQ-5D-5L is a standardized instrument for use as a measure of health outcome that includes a descriptive system consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). For each of the 5 dimensions based on the descriptive system of the EQ-5D-5L, the numbers of participants for all categories (the 5 levels of reported problems) were assessed. For Day +180 Post-HSCT change between baseline in each dimension will be categorized as follows for a specific participant: Condition improved, if the reported level of problem is lower at that assessment than at baseline; Condition unchanged, if the reported level of problem remains the same; Condition deteriorated, if the reported level of problem is higher at that assessment than at baseline; Unknown, if the reported level of problem is not completed or missing either at baseline or at that assessment. (NCT03339297)
Timeframe: Baseline through Day +180 post-HSCT

,
InterventionParticipants (Count of Participants)
Condition improvedCondition unchangedCondition deterioratedUnknown
Defibrotide Prophylaxis234417
Standard of Care Immunoprophylaxis1311019

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Participants With Hypersensitivity Reaction Requiring Discontinuation of Therapy [Safety]

"Hypersensitivity reaction will be assessed using Common Toxicity Criteria for Adverse Events version 4.03.~For grade 2 hypersensitivity reaction, study drug will be held until it resolves to grade 1 or lower. Study drug will be permanently discontinued at grade 3 hypersensitivity reaction or higher. Analyses will be performed for all patients having received at least one dose of study drug." (NCT03384693)
Timeframe: From first treatment with study drug to 6 months post-transplant

InterventionParticipants (Count of Participants)
Prophylactic Defibrotide3

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Number of Patients With Severe TMA

Severe TMA is defined as any TMA meeting the criteria in Objective 2 with the following complications: renal dysfunction requiring dialysis, pleural or pericardial effusion requiring any medical or surgical intervention, central nervous system dysfunction including seizure or posterior reversible encephalopathy syndrome, or death. (NCT03384693)
Timeframe: 6 months post-transplant

InterventionParticipants (Count of Participants)
Prophylactic Defibrotide0

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Number of Patients With TMA Enrolled on the Study

"Evidence of microangiopathy, with either clinical markers/organ dysfunction or presence of biomarkers, or one of the following: 1) presence of schistocytes in peripheral blood; 2) Histologic evidence of microangiopathy on a tissue specimen; 3) Undetectable haptoglobin with increased reticulocyte counts. If there is no evidence of microangiopathy but at least one clinical marker or at least 3 biomarkers, the participant will meet the criteria for TMA incidence.~Based on prior analysis at our center, we anticipated an incidence of TA-TMA of 28.2% (95 CI, 17.8-38.6%) in the high-risk patients undergoing allogeneic transplants and 40% (95% CI, 13.9-69.5%) in the neuroblastoma patients undergoing planned tandem HSCT" (NCT03384693)
Timeframe: 6 months post-transplant

InterventionParticipants (Count of Participants)
Prophylactic Defibrotide1

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Participants With Clinically Significant Bleeding Requiring Discontinuation of Therapy [Safety]

Bleeding was assessed using Common Toxicity Criteria for Adverse Events version 4.03. (CTCAE). Study drug was permanently discontinued at grade 3 bleeding or higher. Analyses will be performed for all patients having received at least one dose of study drug. (NCT03384693)
Timeframe: From first treatment with study drug to 6 months post-transplant

InterventionParticipants (Count of Participants)
Prophylactic Defibrotide3

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Participants With Reportable Serious Adverse Events [Safety] Per CTACAE v5 Grade 3 or Higher

Safety was assessed by evaluating drug-related Serious Adverse Events per CTACAE v5 that occur after prophylactic administration of defibrotide. Analyses will be performed for all patients having received at least one dose of study drug. (NCT03384693)
Timeframe: From first treatment with study drug to 6 months post-transplant

InterventionParticipants (Count of Participants)
Prophylactic Defibrotide3

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Percent of Total Doses of Defibrotide That Were Missed [Feasibility]

Feasibility will be determined with regard to administration concurrently with chemotherapy and supportive medications before, during, and after stem cell infusion. (NCT03384693)
Timeframe: From first treatment with study drug to day +21 post Transplant

Interventionpercentage of missed doses (Median)
Prophylactic Defibrotide0.7

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Incidence of TMA

Evidence of microangiopathy, with either clinical markers/organ dysfunction or presence of biomarkers, or one of the following: 1) presence of schistocytes in peripheral blood; 2) Histologic evidence of microangiopathy on a tissue specimen; 3) Undetectable haptoglobin with increased reticulocyte counts. If there is no evidence of microangiopathy but at least one clinical marker or at least 3 biomarkers, the participant will meet the criteria for TMA incidence. (NCT03384693)
Timeframe: Day 30, day 100 and day 180 post-transplant

InterventionParticipants (Count of Participants)
Day 30day 100Day 180
Prophylactic Defibrotide100

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Incidence of CAR-T-Associated Neurotoxicity Grade 3 or Greater Defined by CTCAE v5.0 by CAR-T Day +30

The secondary efficacy endpoint was the incidence of CAR-T-associated neurotoxicity Grade 3 or greater defined by CTCAE v5.0 by CAR-T Day +30. The results report the estimated percentage of participants with no CAR-T-associated neurotoxicity (Grade 3 or greater defined by CTCAE v5.0) by CAR-T Day +30. (NCT03954106)
Timeframe: By CAR-T Day +30

Interventionpercentage of participants (Number)
Stage 1: Defibrotide, 6.25 mg/kg/Dose80
Stage 2: Defibrotide, 6.25 mg/kg/Dose70
Overall: Defibrotide, 6.25 mg/kg/Dose75

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Incidence of CAR-T-Associated Neurotoxicity of Any Grade According to the ASBMT Consensus Grading System by CAR-T Day +30

The secondary efficacy endpoint was the incidence of CAR-T-associated neurotoxicity of any grade according to ASBMT consensus grading system by CAR-T Day +30. The results report the estimated percentage of participants with no CAR-T-associated neurotoxicity by CAR-T Day +30 summarized descriptively by any grade according to the ASBMT consensus grading system. (NCT03954106)
Timeframe: By CAR-T Day +30

Interventionpercentage of participants (Number)
Stage 1: Defibrotide, 6.25 mg/kg/Dose0
Stage 2: Defibrotide, 6.25 mg/kg/Dose0
Overall: Defibrotide, 6.25 mg/kg/Dose0

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Incidence of CAR-T-associated Neurotoxicity of Any Grade, Defined by CTCAE v5.0 by CAR-T Day +30

The primary efficacy endpoint was the incidence of CAR-T-associated neurotoxicity of any grade defined by CTCAE v5.0 by CAR-T Day +30. The results report the estimated percentage of participants with no CAR-T-associated neurotoxicity of any grade, defined by CTCAE v5.0, which incorporated the 2 stage design. (NCT03954106)
Timeframe: By CAR-T Day +30

Interventionpercentage of participants (Number)
Stage 1: Defibrotide, 6.25 mg/kg/Dose50
Stage 2: Defibrotide, 6.25 mg/kg/Dose50
Overall: Defibrotide, 6.25 mg/kg/Dose51

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Incidence of CAR-T-Associated Neurotoxicity of Grade 3 or Greater According to the ASBMT Consensus Grading System by CAR-T Day +30

The secondary efficacy endpoint was the incidence of CAR-T-associated neurotoxicity grade 3 or greater according to ASBMT consensus grading system by CAR-T Day +30. The results report the estimated percentage of participants with no CAR-T-associated neurotoxicity by CAR-T Day +30 summarized descriptively by grade 3 or greater according to the ASBMT consensus grading system. (NCT03954106)
Timeframe: By CAR-T Day +30

Interventionpercentage of participants (Number)
Stage 1: Defibrotide, 6.25 mg/kg/Dose90
Stage 2: Defibrotide, 6.25 mg/kg/Dose70
Overall: Defibrotide, 6.25 mg/kg/Dose80

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Use of High Dose Steroid By CAR-T Day +30

The percentage of participants using high dose steroids was summarized descriptively. The use of high dose steroids was defined as a dose of dexamethasone of at least 7.5 mg/day or equivalent. Only the Overall Defibrotide: 6.25 mg/kg/dose group was analyzed for this outcome. (NCT03954106)
Timeframe: By CAR-T Day +30

Interventionpercentage of participants (Number)
Overall: Defibrotide, 6.25 mg/kg/Dose45

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Incidence of Cytokine Release Syndrome (CRS) of Any Grade According to the ASBMT Consensus Grading System by CAR-T Day +30

The secondary efficacy endpoint was the incidence of cytokine release syndrome (CRS) of any grade according to ASBMT consensus grading system by CAR-T Day +30. The results report the estimated percentage of participants with no CRS any grade according to ASBMT criteria and was summarized descriptively using the ASBMT consensus grading system by CAR-T Day +30. (NCT03954106)
Timeframe: By CAR-T Day +30

Interventionpercentage of participants (Number)
Stage 1: Defibrotide, 6.25 mg/kg/Dose10
Stage 2: Defibrotide, 6.25 mg/kg/Dose20
Overall: Defibrotide, 6.25 mg/kg/Dose15

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Overall Survival

Number of patients who are alive at Day 28 after starting treatment. (NCT04530604)
Timeframe: 28 days

InterventionParticipants (Count of Participants)
Defibrotide10

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Overall Survival

Number of patients who are alive at Day 14 after starting treatment. (NCT04530604)
Timeframe: 14 days

Interventionparticipants (Number)
Defibrotide11

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Mean Change in the WHO COVID-19 Ordinal Scale During Therapy

"Ordinal scale:~= Ambulatory, no limitation of activities;~= Ambulatory, Activity LImited;~= Hospitalized, no oxygen therapy;~= Oxygen by mask or nasal cannula;~= Non-invasive ventilation or high-flow oxygen (O2);~= Intubation/mechanical ventilation;~= Intubation/Mechanical ventilation plus one of the following: Pressors, Extracorporeal membrane oxygenation (ECMO) or Dialysis;~= Decased/Death Key: For change in ordinal score, negative values represent a decline in WHO score from baseline to day 14 (improvement of condition); positive values represent an increase (worsening of condition)." (NCT04530604)
Timeframe: up to 14 days

Interventionscore on a scale (Mean)
Defibrotide-1

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Number of Major Hemorrhagic Complications Within 14 Days of Initiation of Treatment

"Major hemorrhagic complications will be based on the International Society on Thrombosis and Haemostasis Bleeding scale.~Fatal Bleeding, and/or~Symptomatic bleeding in a critical area or organ, such as intracranial, intraspinal, intraocular, retroperitoneal, intra-articular, pericardial, or intramuscular with compartment syndrome, and/or~Bleeding associated with a decline in hemoglobin level of > 2.0 g/dl, leading to transfusion of two or more units of whole blood or red cells.~In addition, symptomatic alveolar hemorrhage, macroscopic hematuria, uncontrolled menorrhagia or epistaxis or bleeding from any wound site would also be considered a major hemorrhagic event." (NCT04530604)
Timeframe: 14 days

InterventionParticipants (Count of Participants)
Defibrotide0

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Ventilator-free Survival

Day 14 ventilator-free survival will be summarized by the number of patients who are both alive and not using a ventilator at Day 14 after starting treatment. (NCT04530604)
Timeframe: 14 days

InterventionParticipants (Count of Participants)
Defibrotide5

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The Time to Improvement in Oxygenation

Improvement in oxygenation defined as an increase in ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) of 50 (or greater) compared to the nadir of PaO2/FiO2. (NCT04530604)
Timeframe: up to 14 days

Interventiondays (Mean)
Defibrotide4

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Number of Ventilator Free Days Within 14 Days of Study Entry

(NCT04530604)
Timeframe: 14 days

Interventiondays (Median)
Defibrotide0

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