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PLASTIC RECONSTRUCTIVE AND REGENERATIVE SURGERY

Original article

Ahead-of-Print

Effectiveness of oral platelet lysate gel to treat oral mucosal manifestations associated with chronic graft versus host disease

Authors

Arnau Torrent Rodríguez , Thais Lizondo López , Paola Charry , Maria Suárez-Lledó , Maria Margalida Mestre Ribot , Cristina Cremades Artacho , Maria Queralt Salas , Carmen Martínez Muñoz , Montserrat Rovira , Francesc Fernández-Avilés , Carmen López-Cabezas , Laura Aranda-Cortés , Joan Cid , Miquel Lozano

Key words: Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Mouth Ulcer, Platelet-Rich Plasma, Regenerative Medicine
DOI: 10.2450/BloodTransfus.880
Cellular therapy and regenerative medicine
Publication Date: 2025-01-13

Abstract

Background - 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.

Materials and methods - 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.

Results - 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.

Discussion - 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.

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Authors

Arnau Torrent Rodríguez - Pharmacy Service, Department of Medicines, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Thais Lizondo López - Pharmacy Service, Department of Medicines, Hospital Clínic Universitari de Barcelona, Barcelona, Spain https://orcid.org/0009-0007-2699-214X

Paola Charry - Apheresis and Cellular Therapy Unit, Hemotherapy and Hemostasis Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Maria Suárez-Lledó - Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Maria Margalida Mestre Ribot - Pharmacy Service, Department of Medicines, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Cristina Cremades Artacho - Pharmacy Service, Department of Medicines, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Maria Queralt Salas - Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Carmen Martínez Muñoz - Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Montserrat Rovira - Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Francesc Fernández-Avilés - Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Carmen López-Cabezas - Pharmacy Service, Department of Medicines, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Laura Aranda-Cortés - Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Joan Cid - Apheresis and Cellular Therapy Unit, Hemotherapy and Hemostasis Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

Miquel Lozano - Apheresis and Cellular Therapy Unit, Hemotherapy and Hemostasis Department, Institute of Cancer and Hematological Diseases, Hospital Clínic Universitari de Barcelona, Barcelona, Spain

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