Long-term safety and efficacy of autologous platelet lysate drops for treatment of ocular GvHD

Abstract

Current ocular GvHD (oGvHD) treatments are suboptimal. We investigated the safety and efficacy of long-term continuous treatment with autologous platelet lysate (PL) drops in patients with oGvHD Dry Eye Syndrome (DES) score 2-3 refractory to topical conventional therapy. Ophthalmic evaluation was performed at 6 month intervals. Symptoms were assessed using the Glaucoma Symptom Scale (GSS). Patients were defined 'responders' when showing a reduction at least one grade on National Institutes of Health Eye Score from baseline at the 6 month visit. Thirty-one patients were included, and 16 (51%) completed 36 months of follow-up (range 6.5-72.7). At 6 months all patients were classified as responders: median GSS symptom score decreased from 70 to 41 (33 at 36 months), median GSS function score reduced from 68 to 46 (33 at 36 months) (all P<0.001). Median Tear Break Up Time improved from 3 to 6 s after 6 months and was maintained over time. All signs improved at 6 and 36 months (clinical and statistical significance). No severe adverse events occurred. Long-term treatment with PL drops is secure and effective for oGvHD and can be an efficient therapy option from initial stages of oGvHD to prevent permanent ocular impairment and improving quality of life.

Novel therapeutic approaches in utilizing platelet lysate in regenerative medicine: Are we ready for clinical use?

“…PDGF also acts as a vital growth factor in healing soft and hard tissues wounds (Burnouf et al, 2013;Losi et al, 2015). This growth factor is also effective in regular cartilage defect (Tyrnenopoulou, Diakakis, Karayannopoulou, Savvas, & Koliakos, 2016), skin and diabetic foot ulcer repair (Civinini et al, 2013;Stacey, Mata, Trengove, & Mather, 2000), corneal repair (Pezzotta, Del Fante, & Scudeller, 2017), bone healing and bone regeneration (Torreggiani et al, 2014), and angiogenesis (Bari et al, 2018;Burnouf et al, 2013;Civinini et al, 2013).…”

Autologous blood as a source of platelet gel for the effective and safe treatment of oral chronic graft‐versus‐host disease

“…Del Fante and colleagues used autologous platelet lysate mucoadhesive formulation in the treatment of oral cGvHD, and they used allogeneic blood only in patients with thrombocytopenia . Pezzotta and coworkers used autologous platelet lysate drops for treatment of ocular cGvHD . Tahmaz and colleagues demonstrated that the application of autologous serum eye drops in patients with ocular cGvHD was safe and efficient with no side effects in treatments lasting 6 months, although they collected 300 to 450 mL of autologous blood, which was twice the volume collected in our patients …”

Towards the Manufacture of Megakaryocytes and Platelets for Clinical Application

“…In fact, PLTrich blood derivatives, such as PLT-rich plasma, PLT-rich fibrin or PLT releasate, are applied for stem cell-based tissue engineering and regeneration [30]. Moreover, the clinical use of autologous PLT products is proven in the application of PLT lysate drops to prevent graft-versus-host disease (GvHD) [31] or support wound healing in ophthalmology [32]. Hence, advantages and potential applications of PLT products are numerous.…”