Treatment of leg ulcers in β-thalassaemia intermedia: use of platelet-derived wound healing factors from the patient's own platelets
The interesting report by Josifova et al (2001), describes complete healing of an intractable ankle ulcer of nearly 20 years duration after 141 d of treatment with a combination of platelet-derived wound-healing factors (PDWHFs) in a patient with β-thalassaemia intermedia.
We have used the same procedure except that the patient's own platelets were used as a source of PDWHFs in a β-thalassaemia intermedia patient with an ankle ulcer of > 4 years duration who was unresponsive to other procedures, including free skin grafting. Use of the patient's own platelets is potentially safer, and because thalassaemia intermedia patients usually have thrombocytosis it is particularly attractive.
Platelets were obtained by apheresis from the patient, a 26-year-old, transfusion-independent splenectomized man with haemoglobin levels around 9 g/dl. More than 900 × 109/l platelets, were aliquoted in single-dose 2 ml vials under sterile conditions and frozen at −80°C. The preparation was thawed at room temperature before application. We applied a sterile gauze swab moistened with the thawed PDWHFs and firmly bandaged the area, every day from d 1 to d 10 and when granulation tissue developed, on alternative days (d 11 to d 32).
The ulcer surface area was 13 cm2 on d 1 and complete healing was achieved at d 28 of treatment.
As described by Josifova et al (2001), PDWHFs, in our case obtained from the patient's own platelets, may aid the treatment of ulcers in thalassaemia intermedia patients.
