Treatment of leg ulcers in beta-thalassaemia intermedia: use of platelet-derived wound healing factors from the patient's own platelets.

The interesting report by Josifova et al (2001), describescomplete healing of an intractable ankle ulcer of nearly20 years duration after 141 d of treatment with acombination of platelet-derived wound-healing factors(PDWHFs) in a patient with b-thalassaemia intermedia.We have used the same procedure except that thepatient’s own platelets were used as a source of PDWHFsin a b-thalassaemia intermedia patient with an ankle ulcerof .4 years duration who was unresponsive to otherprocedures, including free skin grafting. Use of the patient’sown platelets is potentially safer, and because thalassaemiaintermedia patients usually have thrombocytosis it isparticularly attractive.Platelets were obtained by apheresis from the patient,a 26-year-old, transfusion-independent splenectomizedman with haemoglobin levels around 9 g/dl. Morethan 900 910 /l platelets, were aliquoted in single-dose 2 ml vials under sterile conditions and frozen at2808C. The preparation was thawed at room tempera-ture before application. We applied a sterile gauze swabmoistened with the thawed PDWHFs and firmlybandaged the area, every day from d 1 to d 10 andwhen granulation tissue developed, on alternative days(d 11 to d 32).The ulcer surface area was 13 cm