Platelet gel for treatment of mucocutaneous lesions related to graft-versus-host disease after allogeneic hematopoietic stem cell transplant.
BACKGROUND
Platelet (PLT) gel has been successfully used in tissue regeneration of diabetic/surgical wounds through the releasing of growth factors such as basic fibroblast growth factor and PLT-derived growth factor. Therefore, the PLT gel could represent a therapeutic tool in treating the deep and painful wounds sometimes occurring during graft-versus-host disease (GVHD).


METHODS
The aim of this study was to verify the efficacy and safety of PLT gel for treating GVHD ulcers. Allogeneic hemocomponents were used to obtain PLT gel with an automated system for the on-site preparation and application of patient (autologous) or healthy blood donor (allogeneic)-derived fibrin sealant or PLT-rich fibrin (Vivostat system, Vivostat A/S). Six patients with multiple lesions involving dermis (Grade I, n = 2), subcutaneous (Grade II, n = 4), or oral mucosa and related to GVHD underwent PLT gel as local therapy.


RESULTS
After the second PLT gel application, the pain disappeared in all cases and the granulation tissue was observed in the four patients with Grade II lesions. After a median of eight PLT gel applications (range, 4-10), five of six patients showed a complete response, while one patient with a partial response died early from multiorgan failure. No side effects were documented.


CONCLUSIONS
These preliminary data show that the PLT gel may be used as a safe and effective tool in the management of mucosal skin lesions related to the GVHD.
Picardi
Alessandra
A
Department of Haematology, Stem Cell Transplant Unit, Policlinico Tor Vergata, Rome, Italy. picardi@med.uniroma2.it
Lanti
Alessandro
A
Cudillo
Laura
L
Cerretti
Raffaella
R
Dentamaro
Teresa
T
De Angelis
Gottardo
G
Ferraro
Angelo
A
Di Veroli
Ambra
A
Adorno
Gaspare
G
Arcese
William
W
D000328:Adult; D001331:Automation; D001688:Biological Products / Q000008:administration & dosage / Q000302:isolation & purification / Q000627:therapeutic use*; D001792:Blood Platelets; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage / Q000627:therapeutic use; D005782:Gels; D006086:Graft vs Host Disease / Q000209:etiology / Q000628:therapy*; D019337:Hematologic Neoplasms / Q000150:complications / Q000601:surgery; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019226:Oral Ulcer / Q000209:etiology / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D010865:Pilot Projects; D012038:Regeneration; D012883:Skin Ulcer / Q000209:etiology / Q000628:therapy*; D014014:Tissue Adhesives / Q000008:administration & dosage / Q000627:therapeutic use; D014184:Transplantation, Homologous / Q000009:adverse effects*; D016896:Treatment Outcome
D001688:Biological Products; D015718:Fibrin Tissue Adhesive; D005782:Gels; D036341:Intercellular Signaling Peptides and Proteins; D014014:Tissue Adhesives