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    Clinical Trial Results:
    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 Transplant

    Summary
    EudraCT number
    2017-003309-16
    Trial protocol
    DE   ES   GB   IT   BE   PT   AT   GR   BG   PL   HR  
    Global end of trial date
    12 May 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    18 Apr 2021
    First version publication date
    18 Apr 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    JZP963-201
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03339297
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    IND: 62,118
    Sponsors
    Sponsor organisation name
    Jazz Pharmaceuticals Inc.
    Sponsor organisation address
    3170 Porter Drive, Palo Alto, United States, 94304
    Public contact
    Director, Clinical Trial Disclosure & Transparency, Jazz Pharmaceuticals, Inc., 215 8709177, ClinicalTrialDisclosure@jazzpharma.com
    Scientific contact
    Director, Clinical Trial Disclosure & Transparency, Jazz Pharmaceuticals, Inc., 215 8709177, ClinicalTrialDisclosure@jazzpharma.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    14 Jan 2021
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    12 May 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    12 May 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of the study is to compare the efficacy of defibrotide added to standard of care immunoprophylaxis vs standard of care (SoC) mmunoprophylaxis alone.
    Protection of trial subjects
    Written informed consent and/or assent were obtained before any study procedure were performed in the study and the date of the written consent was obtained and documented.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    15 Jan 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 14
    Country: Number of subjects enrolled
    United Kingdom: 5
    Country: Number of subjects enrolled
    Austria: 7
    Country: Number of subjects enrolled
    Belgium: 12
    Country: Number of subjects enrolled
    Bulgaria: 2
    Country: Number of subjects enrolled
    France: 17
    Country: Number of subjects enrolled
    Germany: 14
    Country: Number of subjects enrolled
    Greece: 3
    Country: Number of subjects enrolled
    Italy: 9
    Country: Number of subjects enrolled
    Canada: 1
    Country: Number of subjects enrolled
    United States: 68
    Worldwide total number of subjects
    152
    EEA total number of subjects
    83
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    3
    Children (2-11 years)
    3
    Adolescents (12-17 years)
    1
    Adults (18-64 years)
    119
    From 65 to 84 years
    26
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Informed consent and/or assent was obtained from participants, parents/legal guardians or representatives.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Defibrotide Prophylaxis
    Arm description
    Eligible participants were randomly assigned to receive defibrotide prophylaxis.
    Arm type
    Experimental

    Investigational medicinal product name
    Defibrotide Prophylaxis
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous drip use
    Dosage and administration details
    Defibrotide solution was administered intravenously by study site personnel at a dose of 25 mg/kg/day.

    Arm title
    Standard of Care (SOC)
    Arm description
    Eligible participants were randomly assigned to receive SoC immunoprophylaxis alone in a 1:1 ratio.
    Arm type
    Active comparator

    Investigational medicinal product name
    SOC
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous drip use
    Dosage and administration details
    Standard of care was administered according to local institutional guidelines, physician preference, and participant need.

    Number of subjects in period 1
    Defibrotide Prophylaxis Standard of Care (SOC)
    Started
    79
    73
    Completed
    56
    59
    Not completed
    23
    14
         Adverse event, serious fatal
    -
    2
         Physician decision
    1
    1
         Relapse of disease new transplant performed
    1
    -
         Disease relapse
    2
    -
         Hepatic candidosis
    1
    -
         Consent withdrawn by subject
    3
    3
         Patient was not eligible
    1
    -
         Adverse event, non-fatal
    1
    -
         Death
    10
    7
         Early termination, did not proceed to transplant
    1
    -
         Patient relapsed and did not proceed to transplant
    -
    1
         Relapse of hematologic disease
    1
    -
         Problems with donor and diagnosis of early relapse
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Defibrotide Prophylaxis
    Reporting group description
    Eligible participants were randomly assigned to receive defibrotide prophylaxis.

    Reporting group title
    Standard of Care (SOC)
    Reporting group description
    Eligible participants were randomly assigned to receive SoC immunoprophylaxis alone in a 1:1 ratio.

    Reporting group values
    Defibrotide Prophylaxis Standard of Care (SOC) Total
    Number of subjects
    79 73 152
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    50.54 ± 16.952 51.09 ± 16.621 -
    Gender categorical
    Units: Subjects
        Female
    38 37 75
        Male
    41 36 77

    End points

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    End points reporting groups
    Reporting group title
    Defibrotide Prophylaxis
    Reporting group description
    Eligible participants were randomly assigned to receive defibrotide prophylaxis.

    Reporting group title
    Standard of Care (SOC)
    Reporting group description
    Eligible participants were randomly assigned to receive SoC immunoprophylaxis alone in a 1:1 ratio.

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

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    End point title
    Percentage of Participants with Cumulative Incidence of Grade B to D Acute Graft Versus Host Disease (aGvHD) by Day +100 post-Hematopoietic Stem Cell Transplant (HSCT)
    End point description
    End point type
    Primary
    End point timeframe
    Baseline through Day +100 post-HSCT
    End point values
    Defibrotide Prophylaxis Standard of Care (SOC)
    Number of subjects analysed
    79
    73
    Units: participants
        number (not applicable)
    38.4
    47.1
    Statistical analysis title
    P-value from Stratified Gray’s Test
    Statistical analysis description
    The treatment comparison on the cumulative incidence of Grade B-D aGvHD over time was conducted using a stratified Gray’s test. The resulting p-value was not applicable to any specific timepoint, but rather the whole duration of the study.
    Comparison groups
    Defibrotide Prophylaxis v Standard of Care (SOC)
    Number of subjects included in analysis
    152
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.6656
    Method
    t-test, 2-sided
    Confidence interval

    Secondary: Percentage of Participants with Cumulative Incidence of Grade B to D aGvHD by Day +180 post-HSCT

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    End point title
    Percentage of Participants with Cumulative Incidence of Grade B to D aGvHD by Day +180 post-HSCT
    End point description
    End point type
    Secondary
    End point timeframe
    Day +180 post-HSCT
    End point values
    Defibrotide Prophylaxis Standard of Care (SOC)
    Number of subjects analysed
    79
    73
    Units: participants
        number (not applicable)
    50.6
    51.6
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse Events (AEs) were reported from the time of signed informed consent form (ICF) and were recorded up to Day +63 post-HSCT for subjects who underwent HSCT, whereas for subjects who did not undergo HSCT, 70 days after baseline.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21.1
    Reporting groups
    Reporting group title
    defibrotide prophylaxis
    Reporting group description
    -

    Reporting group title
    Standard of Care (SOC)
    Reporting group description
    -

    Serious adverse events
    defibrotide prophylaxis Standard of Care (SOC)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    31 / 74 (41.89%)
    31 / 70 (44.29%)
         number of deaths (all causes)
    10
    9
         number of deaths resulting from adverse events
    5
    3
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Acute lymphocytic leukaemia recurrent
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute myeloid leukaemia recurrent
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epstein-Barr virus associated lymphoproliferative disorder
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Obstructive shock
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Shock
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Venoocclusive disease
         subjects affected / exposed
    1 / 74 (1.35%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    General disorders and administration site conditions
    General physical health deterioration
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mucosal haemorrhage
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mucosal inflammation
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    1 / 74 (1.35%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Pyrexia
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Immune system disorders
    Acute graft versus host disease
         subjects affected / exposed
    4 / 74 (5.41%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Acute graft versus host disease in skin
         subjects affected / exposed
    1 / 74 (1.35%)
    4 / 70 (5.71%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Graft versus host disease
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Graft versus host disease in liver
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute graft versus host disease in intestine
         subjects affected / exposed
    2 / 74 (2.70%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory failure
         subjects affected / exposed
    1 / 74 (1.35%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    3 / 74 (4.05%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung disorder
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Pharyngeal inflammation
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 74 (1.35%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Investigations
    Blood potassium decreased
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ejection fraction decreased
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Toxicity to various agents
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transfusion reaction
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Atrial flutter
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac tamponade
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardio-respiratory arrest
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiogenic shock
         subjects affected / exposed
    1 / 74 (1.35%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sinus tachycardia
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stress cardiomyopathy
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Cognitive disorder
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypertensive encephalopathy
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Eosinophilia
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Evans syndrome
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombotic microangiopathy
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute abdomen
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    3 / 74 (4.05%)
    2 / 70 (2.86%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal haemorrhage
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    2 / 74 (2.70%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophagitis
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    2 / 74 (2.70%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Venoocclusive liver disease
         subjects affected / exposed
    0 / 74 (0.00%)
    2 / 70 (2.86%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash vesicular
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Toxic skin eruption
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    3 / 74 (4.05%)
    2 / 70 (2.86%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cystitis haemorrhagic
         subjects affected / exposed
    1 / 74 (1.35%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Arthritis bacterial
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacterial sepsis
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Bronchitis
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cystitis viral
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cytomegalovirus infection
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cytomegalovirus viraemia
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epstein-Barr viraemia
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epstein-Barr virus infection
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fungaemia
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    0 / 74 (0.00%)
    2 / 70 (2.86%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    0 / 74 (0.00%)
    2 / 70 (2.86%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Serratia infection
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Staphylococcal bacteraemia
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection bacterial
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular device infection
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    2 / 74 (2.70%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Failure to thrive
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    0 / 74 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypovolaemia
         subjects affected / exposed
    1 / 74 (1.35%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    defibrotide prophylaxis Standard of Care (SOC)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    74 / 74 (100.00%)
    70 / 70 (100.00%)
    Vascular disorders
    Flushing
         subjects affected / exposed
    4 / 74 (5.41%)
    4 / 70 (5.71%)
         occurrences all number
    6
    4
    Hypertension
         subjects affected / exposed
    25 / 74 (33.78%)
    29 / 70 (41.43%)
         occurrences all number
    40
    32
    Hypotension
         subjects affected / exposed
    13 / 74 (17.57%)
    11 / 70 (15.71%)
         occurrences all number
    16
    14
    Orthostatic hypotension
         subjects affected / exposed
    6 / 74 (8.11%)
    3 / 70 (4.29%)
         occurrences all number
    6
    3
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    9 / 74 (12.16%)
    6 / 70 (8.57%)
         occurrences all number
    12
    6
    Catheter site pain
         subjects affected / exposed
    8 / 74 (10.81%)
    9 / 70 (12.86%)
         occurrences all number
    10
    10
    Chills
         subjects affected / exposed
    7 / 74 (9.46%)
    6 / 70 (8.57%)
         occurrences all number
    8
    7
    Fatigue
         subjects affected / exposed
    25 / 74 (33.78%)
    25 / 70 (35.71%)
         occurrences all number
    32
    27
    Mucosal inflammation
         subjects affected / exposed
    10 / 74 (13.51%)
    17 / 70 (24.29%)
         occurrences all number
    11
    24
    Oedema peripheral
         subjects affected / exposed
    19 / 74 (25.68%)
    21 / 70 (30.00%)
         occurrences all number
    125
    24
    Pain
         subjects affected / exposed
    5 / 74 (6.76%)
    6 / 70 (8.57%)
         occurrences all number
    7
    7
    Pyrexia
         subjects affected / exposed
    28 / 74 (37.84%)
    24 / 70 (34.29%)
         occurrences all number
    38
    34
    Immune system disorders
    Graft versus host disease in skin
         subjects affected / exposed
    4 / 74 (5.41%)
    2 / 70 (2.86%)
         occurrences all number
    4
    2
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    17 / 74 (22.97%)
    16 / 70 (22.86%)
         occurrences all number
    20
    20
    Dyspnoea
         subjects affected / exposed
    8 / 74 (10.81%)
    12 / 70 (17.14%)
         occurrences all number
    12
    19
    Epistaxis
         subjects affected / exposed
    12 / 74 (16.22%)
    11 / 70 (15.71%)
         occurrences all number
    13
    13
    Hiccups
         subjects affected / exposed
    5 / 74 (6.76%)
    3 / 70 (4.29%)
         occurrences all number
    5
    3
    Hypoxia
         subjects affected / exposed
    4 / 74 (5.41%)
    3 / 70 (4.29%)
         occurrences all number
    4
    7
    Nasal congestion
         subjects affected / exposed
    4 / 74 (5.41%)
    1 / 70 (1.43%)
         occurrences all number
    6
    1
    Oropharyngeal pain
         subjects affected / exposed
    9 / 74 (12.16%)
    12 / 70 (17.14%)
         occurrences all number
    9
    14
    Pleural effusion
         subjects affected / exposed
    4 / 74 (5.41%)
    3 / 70 (4.29%)
         occurrences all number
    6
    4
    Productive cough
         subjects affected / exposed
    5 / 74 (6.76%)
    0 / 70 (0.00%)
         occurrences all number
    6
    0
    Rales
         subjects affected / exposed
    4 / 74 (5.41%)
    2 / 70 (2.86%)
         occurrences all number
    4
    4
    Rhinitis allergic
         subjects affected / exposed
    2 / 74 (2.70%)
    4 / 70 (5.71%)
         occurrences all number
    2
    4
    Rhinorrhoea
         subjects affected / exposed
    6 / 74 (8.11%)
    9 / 70 (12.86%)
         occurrences all number
    7
    9
    Tachypnoea
         subjects affected / exposed
    4 / 74 (5.41%)
    2 / 70 (2.86%)
         occurrences all number
    5
    2
    Psychiatric disorders
    Agitation
         subjects affected / exposed
    5 / 74 (6.76%)
    3 / 70 (4.29%)
         occurrences all number
    5
    3
    Anxiety
         subjects affected / exposed
    11 / 74 (14.86%)
    9 / 70 (12.86%)
         occurrences all number
    11
    9
    Confusional state
         subjects affected / exposed
    5 / 74 (6.76%)
    3 / 70 (4.29%)
         occurrences all number
    6
    3
    Delirium
         subjects affected / exposed
    4 / 74 (5.41%)
    2 / 70 (2.86%)
         occurrences all number
    5
    2
    Depression
         subjects affected / exposed
    7 / 74 (9.46%)
    2 / 70 (2.86%)
         occurrences all number
    7
    2
    Insomnia
         subjects affected / exposed
    22 / 74 (29.73%)
    16 / 70 (22.86%)
         occurrences all number
    24
    18
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    3 / 74 (4.05%)
    7 / 70 (10.00%)
         occurrences all number
    7
    10
    Aspartate aminotransferase increased
         subjects affected / exposed
    2 / 74 (2.70%)
    5 / 70 (7.14%)
         occurrences all number
    2
    6
    Bacterial test positive
         subjects affected / exposed
    4 / 74 (5.41%)
    3 / 70 (4.29%)
         occurrences all number
    5
    6
    Blood bilirubin increased
         subjects affected / exposed
    3 / 74 (4.05%)
    5 / 70 (7.14%)
         occurrences all number
    5
    13
    Blood creatinine increased
         subjects affected / exposed
    12 / 74 (16.22%)
    6 / 70 (8.57%)
         occurrences all number
    14
    6
    Blood magnesium decreased
         subjects affected / exposed
    1 / 74 (1.35%)
    4 / 70 (5.71%)
         occurrences all number
    1
    6
    C-reactive protein increased
         subjects affected / exposed
    4 / 74 (5.41%)
    5 / 70 (7.14%)
         occurrences all number
    4
    6
    Epstein-Barr virus test positive
         subjects affected / exposed
    4 / 74 (5.41%)
    2 / 70 (2.86%)
         occurrences all number
    4
    2
    Neutrophil count decreased
         subjects affected / exposed
    8 / 74 (10.81%)
    11 / 70 (15.71%)
         occurrences all number
    20
    23
    Platelet count decreased
         subjects affected / exposed
    19 / 74 (25.68%)
    21 / 70 (30.00%)
         occurrences all number
    54
    56
    Transaminases increased
         subjects affected / exposed
    4 / 74 (5.41%)
    6 / 70 (8.57%)
         occurrences all number
    4
    7
    Weight decreased
         subjects affected / exposed
    3 / 74 (4.05%)
    4 / 70 (5.71%)
         occurrences all number
    4
    5
    White blood cell count decreased
         subjects affected / exposed
    8 / 74 (10.81%)
    6 / 70 (8.57%)
         occurrences all number
    15
    17
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    5 / 74 (6.76%)
    2 / 70 (2.86%)
         occurrences all number
    5
    2
    Infusion related reaction
         subjects affected / exposed
    4 / 74 (5.41%)
    6 / 70 (8.57%)
         occurrences all number
    4
    6
    Limb injury
         subjects affected / exposed
    4 / 74 (5.41%)
    1 / 70 (1.43%)
         occurrences all number
    5
    1
    Skin abrasion
         subjects affected / exposed
    1 / 74 (1.35%)
    4 / 70 (5.71%)
         occurrences all number
    1
    5
    Cardiac disorders
    Sinus tachycardia
         subjects affected / exposed
    9 / 74 (12.16%)
    8 / 70 (11.43%)
         occurrences all number
    10
    12
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    10 / 74 (13.51%)
    8 / 70 (11.43%)
         occurrences all number
    11
    12
    Dysgeusia
         subjects affected / exposed
    10 / 74 (13.51%)
    9 / 70 (12.86%)
         occurrences all number
    12
    9
    Headache
         subjects affected / exposed
    31 / 74 (41.89%)
    23 / 70 (32.86%)
         occurrences all number
    40
    36
    Restless legs syndrome
         subjects affected / exposed
    5 / 74 (6.76%)
    1 / 70 (1.43%)
         occurrences all number
    5
    1
    Somnolence
         subjects affected / exposed
    5 / 74 (6.76%)
    2 / 70 (2.86%)
         occurrences all number
    7
    2
    Tremor
         subjects affected / exposed
    10 / 74 (13.51%)
    9 / 70 (12.86%)
         occurrences all number
    11
    10
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    27 / 74 (36.49%)
    30 / 70 (42.86%)
         occurrences all number
    49
    60
    Febrile neutropenia
         subjects affected / exposed
    30 / 74 (40.54%)
    20 / 70 (28.57%)
         occurrences all number
    32
    20
    Leukopenia
         subjects affected / exposed
    9 / 74 (12.16%)
    6 / 70 (8.57%)
         occurrences all number
    18
    12
    Neutropenia
         subjects affected / exposed
    12 / 74 (16.22%)
    17 / 70 (24.29%)
         occurrences all number
    28
    28
    Thrombocytopenia
         subjects affected / exposed
    19 / 74 (25.68%)
    19 / 70 (27.14%)
         occurrences all number
    36
    41
    Eye disorders
    Dry eye
         subjects affected / exposed
    15 / 74 (20.27%)
    6 / 70 (8.57%)
         occurrences all number
    15
    7
    Eye swelling
         subjects affected / exposed
    0 / 74 (0.00%)
    4 / 70 (5.71%)
         occurrences all number
    0
    4
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    8 / 74 (10.81%)
    5 / 70 (7.14%)
         occurrences all number
    13
    6
    Abdominal pain
         subjects affected / exposed
    13 / 74 (17.57%)
    22 / 70 (31.43%)
         occurrences all number
    18
    24
    Abdominal pain lower
         subjects affected / exposed
    4 / 74 (5.41%)
    0 / 70 (0.00%)
         occurrences all number
    4
    0
    Abdominal pain upper
         subjects affected / exposed
    5 / 74 (6.76%)
    9 / 70 (12.86%)
         occurrences all number
    7
    15
    Constipation
         subjects affected / exposed
    28 / 74 (37.84%)
    29 / 70 (41.43%)
         occurrences all number
    34
    37
    Diarrhoea
         subjects affected / exposed
    47 / 74 (63.51%)
    53 / 70 (75.71%)
         occurrences all number
    71
    77
    Dry mouth
         subjects affected / exposed
    7 / 74 (9.46%)
    6 / 70 (8.57%)
         occurrences all number
    8
    6
    Dyspepsia
         subjects affected / exposed
    4 / 74 (5.41%)
    11 / 70 (15.71%)
         occurrences all number
    4
    13
    Dysphagia
         subjects affected / exposed
    5 / 74 (6.76%)
    3 / 70 (4.29%)
         occurrences all number
    6
    7
    Flatulence
         subjects affected / exposed
    4 / 74 (5.41%)
    3 / 70 (4.29%)
         occurrences all number
    4
    3
    Haemorrhoids
         subjects affected / exposed
    6 / 74 (8.11%)
    6 / 70 (8.57%)
         occurrences all number
    10
    6
    Mouth ulceration
         subjects affected / exposed
    4 / 74 (5.41%)
    1 / 70 (1.43%)
         occurrences all number
    5
    1
    Nausea
         subjects affected / exposed
    56 / 74 (75.68%)
    49 / 70 (70.00%)
         occurrences all number
    89
    70
    Odynophagia
         subjects affected / exposed
    7 / 74 (9.46%)
    3 / 70 (4.29%)
         occurrences all number
    9
    3
    Oesophagitis
         subjects affected / exposed
    5 / 74 (6.76%)
    0 / 70 (0.00%)
         occurrences all number
    7
    0
    Stomatitis
         subjects affected / exposed
    42 / 74 (56.76%)
    36 / 70 (51.43%)
         occurrences all number
    68
    69
    Vomiting
         subjects affected / exposed
    39 / 74 (52.70%)
    38 / 70 (54.29%)
         occurrences all number
    66
    62
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    5 / 74 (6.76%)
    3 / 70 (4.29%)
         occurrences all number
    5
    3
    Dry skin
         subjects affected / exposed
    7 / 74 (9.46%)
    8 / 70 (11.43%)
         occurrences all number
    7
    8
    Erythema
         subjects affected / exposed
    13 / 74 (17.57%)
    13 / 70 (18.57%)
         occurrences all number
    18
    19
    Hyperhidrosis
         subjects affected / exposed
    4 / 74 (5.41%)
    1 / 70 (1.43%)
         occurrences all number
    4
    1
    Petechiae
         subjects affected / exposed
    2 / 74 (2.70%)
    4 / 70 (5.71%)
         occurrences all number
    2
    4
    Pruritus
         subjects affected / exposed
    11 / 74 (14.86%)
    13 / 70 (18.57%)
         occurrences all number
    13
    15
    Pruritus generalised
         subjects affected / exposed
    4 / 74 (5.41%)
    5 / 70 (7.14%)
         occurrences all number
    5
    6
    Rash
         subjects affected / exposed
    17 / 74 (22.97%)
    19 / 70 (27.14%)
         occurrences all number
    31
    27
    Rash maculo-papular
         subjects affected / exposed
    7 / 74 (9.46%)
    7 / 70 (10.00%)
         occurrences all number
    10
    7
    Skin hyperpigmentation
         subjects affected / exposed
    2 / 74 (2.70%)
    5 / 70 (7.14%)
         occurrences all number
    2
    5
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    17 / 74 (22.97%)
    16 / 70 (22.86%)
         occurrences all number
    22
    21
    Cystitis haemorrhagic
         subjects affected / exposed
    2 / 74 (2.70%)
    4 / 70 (5.71%)
         occurrences all number
    2
    6
    Dysuria
         subjects affected / exposed
    6 / 74 (8.11%)
    5 / 70 (7.14%)
         occurrences all number
    7
    6
    Haematuria
         subjects affected / exposed
    3 / 74 (4.05%)
    4 / 70 (5.71%)
         occurrences all number
    4
    5
    Pollakiuria
         subjects affected / exposed
    4 / 74 (5.41%)
    4 / 70 (5.71%)
         occurrences all number
    6
    4
    Urinary retention
         subjects affected / exposed
    4 / 74 (5.41%)
    0 / 70 (0.00%)
         occurrences all number
    4
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    10 / 74 (13.51%)
    6 / 70 (8.57%)
         occurrences all number
    11
    8
    Back pain
         subjects affected / exposed
    8 / 74 (10.81%)
    12 / 70 (17.14%)
         occurrences all number
    9
    13
    Bone pain
         subjects affected / exposed
    3 / 74 (4.05%)
    4 / 70 (5.71%)
         occurrences all number
    4
    4
    Musculoskeletal pain
         subjects affected / exposed
    6 / 74 (8.11%)
    1 / 70 (1.43%)
         occurrences all number
    8
    1
    Myalgia
         subjects affected / exposed
    6 / 74 (8.11%)
    2 / 70 (2.86%)
         occurrences all number
    7
    2
    Neck pain
         subjects affected / exposed
    5 / 74 (6.76%)
    3 / 70 (4.29%)
         occurrences all number
    6
    3
    Pain in extremity
         subjects affected / exposed
    5 / 74 (6.76%)
    3 / 70 (4.29%)
         occurrences all number
    7
    3
    Infections and infestations
    Clostridium difficile colitis
         subjects affected / exposed
    3 / 74 (4.05%)
    4 / 70 (5.71%)
         occurrences all number
    3
    4
    Cytomegalovirus infection
         subjects affected / exposed
    11 / 74 (14.86%)
    14 / 70 (20.00%)
         occurrences all number
    12
    15
    Oral candidiasis
         subjects affected / exposed
    0 / 74 (0.00%)
    6 / 70 (8.57%)
         occurrences all number
    0
    7
    Urinary tract infection
         subjects affected / exposed
    3 / 74 (4.05%)
    6 / 70 (8.57%)
         occurrences all number
    3
    7
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    30 / 74 (40.54%)
    30 / 70 (42.86%)
         occurrences all number
    39
    37
    Dehydration
         subjects affected / exposed
    4 / 74 (5.41%)
    5 / 70 (7.14%)
         occurrences all number
    4
    5
    Fluid overload
         subjects affected / exposed
    5 / 74 (6.76%)
    5 / 70 (7.14%)
         occurrences all number
    5
    6
    Fluid retention
         subjects affected / exposed
    6 / 74 (8.11%)
    4 / 70 (5.71%)
         occurrences all number
    9
    10
    Hyperglycaemia
         subjects affected / exposed
    12 / 74 (16.22%)
    9 / 70 (12.86%)
         occurrences all number
    24
    17
    Hyperkalaemia
         subjects affected / exposed
    5 / 74 (6.76%)
    8 / 70 (11.43%)
         occurrences all number
    5
    12
    Hypernatraemia
         subjects affected / exposed
    2 / 74 (2.70%)
    5 / 70 (7.14%)
         occurrences all number
    6
    5
    Hypoalbuminaemia
         subjects affected / exposed
    8 / 74 (10.81%)
    2 / 70 (2.86%)
         occurrences all number
    9
    3
    Hypocalcaemia
         subjects affected / exposed
    3 / 74 (4.05%)
    5 / 70 (7.14%)
         occurrences all number
    3
    9
    Hypokalaemia
         subjects affected / exposed
    24 / 74 (32.43%)
    27 / 70 (38.57%)
         occurrences all number
    36
    44
    Hypomagnesaemia
         subjects affected / exposed
    30 / 74 (40.54%)
    35 / 70 (50.00%)
         occurrences all number
    52
    59
    Hyponatraemia
         subjects affected / exposed
    8 / 74 (10.81%)
    5 / 70 (7.14%)
         occurrences all number
    9
    6
    Hypophagia
         subjects affected / exposed
    1 / 74 (1.35%)
    5 / 70 (7.14%)
         occurrences all number
    1
    6
    Hypophosphataemia
         subjects affected / exposed
    5 / 74 (6.76%)
    11 / 70 (15.71%)
         occurrences all number
    9
    25
    Malnutrition
         subjects affected / exposed
    4 / 74 (5.41%)
    6 / 70 (8.57%)
         occurrences all number
    4
    6

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 Jun 2018
    Section 4.1 Inclusion criteria: #1 updated to remove upper limit of age <75 years for inclusion. #8 to remove requirement of negative serum pregnancy tests at Days +28 and +63 post-HSCT. Section 4.2 Exclusion criteria: #3 updated to clarify that use of heparin or other anticoagulants for routine central venous line management, and intermittent dialysis or ultrafiltration as well as fibrinolytic instillation for central venous line occlusion will be allowed. #5 updated to exclude patients receiving or planning to receive other investigational therapy #11 updated to add description on hypersensitivity to any agent in patient’s planned immunoprophylaxis regimen. Added #12 on patient having any contraindications to agent(s) within immunoprophylaxis regimens allowed by protocol order to address contraindications, special precautions, and warnings for medicinal products used as standard of care (SoC). Section 5.1.2 & 5.2.2 updated to add a clarification to a reference SmPC or approved label for warnings and precautions associated with reference therapy. Section 5.2.1 to provide info on administration setting and guidance on defibrotide dosing window. Section 5.7.5 to remove prohibition against all investigational therapies. Section 6.8 to clarify that clinically significant laboratory values are to be reported as adverse events only if they are clinically significant as assessed by the investigator. Patients who do not receive HSCT, AEs will be collected up to 70 days after baseline. Section 6.8.1.7 Pregnancy has been harmonised with language in Section 6.9.1pregnancy is a reason why study drug must be permanently discontinued. Section 6.9.1 to differentiate reasons for discontinuation of a patient from the study and discontinuation from the study drug, and to differentiate between reason that ‘must’ and that ‘may’ lead to an early termination. Section 7.1 & 7.3 to clarify that bone marrow aspirate and biopsy are required for assessment of disease relapse.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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