Autologous skin cell suspension transplant efficacious in vitiligo

Key takeaways:

• Repigmentation of at least 80% was achieved in 36% of areas treated with ASCS compared with 0% of control areas at week 24.
• At week 52, 40% of treatment areas achieved this milestone vs. 0% of control areas.

Autologous skin cell suspension transplantation using a cell harvesting device was shown to be effective and well tolerated in vitiligo treatment, according to a study.

“Vitiligo surgery is one of the most effective ways to rapidly repigment skin, because most treatments for vitiligo take a long time to work and require a lot of maintenance treatments,” Iltefat H. Hamzavi, MD, of the department of dermatology at Henry Ford Health System, told Healio.

While surgical intervention for vitiligo has been used around the world for years, it can be difficult due to expertise and equipment barriers and high donor-to-recipient site ratios.

Iltefat H. Hamzavi

With a 1:20 donor-to-recipient ratio, the RECELL autologous cell harvesting device (Avita Medical) prepares non-cultured autologous skin cell suspension (ASCS) at the point-of-care, according to the study.

A randomized, prospective, central evaluator-blinded, within-subject controlled trial compared laser ablation and ASCS application with narrow band ultraviolet B (NB-UVB) therapy vs. targeted NB-UVB alone. The primary endpoint was the proportion of lesions that attained 80% or higher repigmentation by week 24.

Adults with vitiligo over less than 30% of their body surface area and two stable depigmented areas that were similar in size, sun exposure, extend of leukotrichia and at least 90% depigmented were included. An independent screening committee evaluated photographs of all study areas.

Each of the 25 patients received local anesthetic and laser ablation before ASCS treatment on the study area and NB-UVB on both the study area and the control area.

At week 24, 36% of the ASCS-treated areas showed repigmentation of at least 80% compared with 0% of the control areas (P < .025). This increased to 40% by week 52, with no control areas reaching this milestone.

Repigmentation of at least 50% was achieved in 56% of the treatment areas compared with 12% of the control areas at week 24.

Additionally at week 24, 68% of ASCS treated areas and 80% of control areas with any repigmentation had “good” or “excellent” color matching, which increased to 88% and 61% at week 52, respectively.

Adverse events were similar in both control and treatment areas with nine adverse events reported among five patients.

“Vitiligo is a two-step process. The immunology causes the destruction of melanocytes, but the melanocytes also take forever to repigment,” Hamzavi said. “By doing surgery you rapidly move the melanocytes to where they need to be, and then by removing the top layer of skin, you are altering the host environment to make them more acceptable for a graft.”

For more information:

Iltefat Hamzavi, MD, can be reached at Ihamzav1@hfhs.org.