Blood Transfusion最新文献

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.

Background: Although topical corticosteroids (TCS) represent first-line treatment for vulvar lichen sclerosus (VLS) and as such should be prescribed to all women at time of diagnosis, approximately 30% of patients do not experience complete symptom resolution following such treatment. TCS may not effectively improve vulvar trophism and elasticity, both of which are crucial for sexual function. Owing to its regenerative and healing properties, cord blood platelet-rich plasma (CB-PRP) may represent an efficacious supplementary therapy, to be administered following first line treatment with TCS. The primary aim of this study was to assess safety and tolerability of CB-PRP in women with VLS.

Materials and methods: This is a pilot study which precedes a randomized controlled trial of CB-PRP vs placebo in women with VLS. Ten consecutive patients with VLS, who had previously undergone standard TCS-treatment, received three vulvar CB-PRP injections monthly. Follow-up was conducted three months after the last injection using vulvoscopy and validated questionnaires to evaluate safety and tolerability, as well as patient satisfaction, symptom improvement, sexual function, psychological well-being, quality of life, frequency of TCS application as a maintenance treatment, vulvar trophism and architectural modifications.

Results: No adverse clinical effects were observed. Five patients (50%) were either satisfied or very satisfied with the procedure, four (40%) were uncertain about their satisfaction with the treatment. One patient (10%) dropped out for personal reasons and was classified as unsatisfied according to an intention-to-treat analysis. At follow-up median numeric rating scale scores were significantly reduced for vulvar burning compared to baseline (p<0.05) there was a trend toward improvement in itching, dyspareunia, and dysuria. A significant improvement in sexual arousal and satisfaction was observed in all treated women (p<0.05).

Discussion: CB-PRP may be a promising treatment for VLS. It appears to be safe and improve symptoms and sexual function.

Parvovirus B19 (B19V) presents a significant concern in the context of blood transfusion safety, given its potential for transmission through contaminated blood products, and the increased viral circulation recently reported across Europe. This study examines the recent epidemiological trends of B19V in Italy, where a notable increase in B19V-positive plasma units was observed during early 2024. While routine NAT testing for B19V in individual blood donations is not currently justified, the existing screening protocols for plasma intended for industrial fractionation are crucial to ensure the safety of plasma-derived medicinal products. However, this situation requires careful consideration of the optimal management of viremic donors and the implementation of targeted look back procedures to trace and monitor recipients of labile blood components. To address these issues, we propose an algorithm for managing both donors and recipients in cases of B19V positivity. These measures aim to balance recipient safety with minimising donor loss, while also addressing significant operational and ethical considerations within blood establishments.