Torrent-Rodríguez Arnau, Lizondo-López Thais, Charry Paola, Suárez-Lledó Maria, Mestre-Ribot Maria M, Cremades-Artacho Cristina, Salas Maria Queralt, Muñoz Carmen Martínez, Rovira Montserrat, Fernández-Avilés Francesc, López-Cabezas Carmen, Aranda-Cortés Laura, Cid Joan, Lozano Miquel
Pharmacy Service, Department of Medicines, Hospital Clínic Universitari de Barcelona, Barcelona, Spain.
Apheresis and Cellular Therapy Unit, Hemotherapy and Hemostasis Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari de Barcelona, Barcelona, Spain.
Blood Transfus. 2025 Sep-Oct;23(5):461-468. doi: 10.2450/BloodTransfus.880. Epub 2025 Jan 13.
Chronic graft-vs-host disease (cGvHD) is a severe immune-mediated complication that affects patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Oral manifestations of cGvHD, such as ulcers and mucosal inflammation, significantly impair quality of life and often require long-term treatment. Existing therapies provide limited relief, prompting the exploration of new approaches, including the use of autologous platelet lysate (PL) gel for its regenerative properties.
This observational study evaluated the effectiveness and safety of a topical autologous PL gel in treating oral ulcers associated with cGvHD in seven patients who had undergone allo-HSCT for hematological malignancies. The PL gel was prepared by mixing autologous PL with a gel base under aseptic conditions, and patients applied the gel three times daily. Clinical assessments, including the severity of oral damage and pain levels, were conducted using the NIH-CTCAE scale.
Of the seven patients treated, five completed the study with a median follow-up of 20 months. Significant reductions in oral damage severity and pain levels were observed, with a p-value of 0.0495 for symptom severity and 0.0196 for pain reduction. The average adherence rate was 81.4%, and no adverse effects were reported.
The study demonstrated that autologous PL gel is a promising and well-tolerated treatment for oral manifestations of cGvHD, offering significant symptom relief. Despite the small sample size, these findings align with previous studies and support further research into PL gel as a therapeutic option in cGvHD management.
慢性移植物抗宿主病（cGvHD）是一种严重的免疫介导并发症，影响异基因造血干细胞移植（allo-HSCT）后的患者。cGvHD的口腔表现，如溃疡和黏膜炎症，会显著损害生活质量，且常常需要长期治疗。现有疗法缓解效果有限，这促使人们探索新方法，包括使用具有再生特性的自体血小板裂解液（PL）凝胶。
本观察性研究评估了局部应用自体PL凝胶治疗7例因血液系统恶性肿瘤接受allo-HSCT患者的cGvHD相关口腔溃疡的有效性和安全性。PL凝胶是在无菌条件下将自体PL与凝胶基质混合制备而成，患者每天涂抹3次该凝胶。使用美国国立卫生研究院常见不良反应事件评价标准（NIH-CTCAE）量表进行临床评估，包括口腔损伤严重程度和疼痛程度。
在接受治疗的7例患者中，5例完成了研究，中位随访时间为20个月。观察到口腔损伤严重程度和疼痛程度显著降低，症状严重程度的p值为0.0495，疼痛减轻的p值为0.0196。平均依从率为81.4%，未报告不良反应。
该研究表明，自体PL凝胶是一种有前景且耐受性良好的治疗cGvHD口腔表现的方法，能显著缓解症状。尽管样本量较小，但这些发现与先前研究一致，并支持进一步研究将PL凝胶作为cGvHD管理中的一种治疗选择。
