Department of Haematology, Stem Cell Transplant Unit, Policlinico Tor Vergata, Rome, Italy.
Transfusion. 2010 Feb;50(2):501-6. doi: 10.1111/j.1537-2995.2009.02439.x. Epub 2009 Oct 9.
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).
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.
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.
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.
血小板凝胶通过释放碱性成纤维细胞生长因子和血小板衍生生长因子等生长因子，已成功应用于糖尿病/手术伤口的组织再生。因此，血小板凝胶可作为治疗移植物抗宿主病（GVHD）时发生的深部和疼痛性溃疡的治疗工具。
本研究旨在验证血小板凝胶治疗 GVHD 溃疡的疗效和安全性。使用同种异体血液成分，通过自动化系统现场制备并应用患者（自体）或健康献血者（异体）来源的纤维蛋白胶或富含血小板的纤维蛋白（Vivostat 系统，Vivostat A/S），获得血小板凝胶。6 例患者有多个累及真皮（I 级，n=2）、皮下组织（II 级，n=4）或口腔黏膜的病变，与 GVHD 相关，均接受了血小板凝胶的局部治疗。
在第二次应用血小板凝胶后，所有病例的疼痛均消失，4 例 II 级病变患者观察到肉芽组织。在中位数为 8 次血小板凝胶应用（范围 4-10 次）后，6 例患者中有 5 例完全缓解，而 1 例部分缓解的患者因多器官衰竭早期死亡。未记录到不良反应。
这些初步数据表明，血小板凝胶可用作治疗与 GVHD 相关的黏膜皮肤病变的安全有效工具。
