用去纤苷治疗时可能产生什么不良现象？

In recent years, multiple clinical research results have shown that defibrotide (defiteli) is a safe and effective drug for preventing and treating hepatic veno-occlusive disease after hematopoietic stem cell transplantation. So, what adverse phenomena may occur when treating with defibrotide (defiteli)?

Defibrotide (defiteli) is an adenosine receptor agonist with multiple effects. The adenosine A1/A2 receptors of endothelial cells are involved in the regulation of endothelial cells and the response of endothelial cells to injury. Defibrotide (defiteli) can act on these receptors to produce a variety of downstream effects. Defibrotide (defiteli) can also reduce the expression of cell adhesion molecules on the surface of endothelial cells, thereby reducing the adhesion of leukocytes to vascular endothelial cells and reducing the inflammatory damage of endothelial cells.

In addition, defibrotide (defiteli) can also promote the release of prostaglandin I2 (PGI2) and prostaglandin E2 (PGE2), thereby causing blood vessel dilation, inhibiting platelet aggregation, and reducing ischemic damage. Studies have shown that defibrotide (defiteli) can significantly increase the expression of thrombin regulatory protein (TM) and tissue factor pathway inhibitors to produce anticoagulant effects. 

The recommended dose of defibrotide (defiteli) is 6.25 mg/kg given every 6 hours as a 2-hour intravenous infusion. Treatment lasts for a minimum of 21 days. If signs and symptoms of VOD do not resolve after 21 days, continue treatment until resolution. 

Defibrotide (defiteli) has received marketing authorization from the European Commission for the treatment of severe hepatic VOD in hematopoietic stem cell transplantation (HSCT). A phase 3 randomized controlled trial of defibrotide (defiteli) for the prevention of hepatic VOD in pediatric transplant patients has also been completed. Defibrotide has been generally well tolerated; the most common side effects observed during premarketing use to treat hepatic VOD were bleeding, hypotension, and coagulopathy.

The above are the adverse phenomena that may occur during treatment with defibrotide (defiteli). If they occur, please inform your doctor in time for treatment.