用Defibrotide会产生哪些不良反应？

For some patients with leukemia and lymphoma, hematopoietic stem cell transplantation (HSCT) is the only hope to cure the disease and regain health. Hepatic veno-occlusive disease (HVOD) is one of the serious complications after hematopoietic stem cell transplantation (HSCT), and the mortality rate in patients with severe HVOD can be as high as 100%. Defibrotide (produced in Italy) is a mixture of single-stranded oligonucleotides with antithrombotic and fibrinolytic effects.

Defibrotide is currently recognized as the most promising new drug for the treatment of hepatic veno-occlusive disease (HVOD) after hematopoietic stem cell transplantation (HSCT). Defibrotide has anticoagulant and fibrinolysis effects, and also promotes vascularization. Basic fibroblast growth factor (bFGF) has the effect of stimulating vascularization. Some studies have found that Defibrotide can not only combine with basic fibroblast growth factor (bFGF) to mobilize bFGF from the extracellular matrix, but also protect bFGF from protease degradation, thereby stimulating angiogenesis.

  The recommended dose of Defibrotide 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. A phase 3 randomized controlled trial of defibrotide for the prevention of hepatic VOD in pediatric transplant patients has also been completed. Defibrotide has been generally well tolerated; the most common adverse reactions observed with defibrotide during premarketing use to treat hepatic VOD were bleeding, hypotension, and coagulopathy.

  Hypersensitivity reactions have occurred in less than 2% of patients treated with Defibrotide. These reactions include rash, urticaria, and angioedema. One case of anaphylactic reaction was reported in a patient who had previously received Defibrotide. Monitor patients for hypersensitivity reactions. Especially if there is a history of previous exposure. If a severe hypersensitivity reaction occurs, discontinue Defibrotide, treat with standard medical care, and monitor until symptoms resolve.