Autologous Bone Marrow Stem Cell Research Articles

Effect of Autologous Bone Marrow Stem Cell Therapy in Patients with Liver Cirrhosis: A Meta-analysis.

Background and Aims: Although autologous bone marrow stem cell (BMSC) transplantation is an effective treatment for liver cirrhosis, there are few reports describing the optimal delivery route and number of injected BMSCs.Methods: A literature search was conducted using PubMed, ISI Web of Science, Cochrane Central Register of Controlled Trials, and EBSCO. A meta-analysis was performed to assess the effect of BMSCs on liver and coagulation function indices. Subgroup analysis was performed based on number of injected BMSCs, delivery route, and length of follow-up.Results: A total of 15 studies were selected from among 1903 potential studies for analysis. Autologous BMSC transplantation significantly improved aspartate aminotransferase, total bilirubin, albumin, prothrombin time, prothrombin activity, prothrombin concentration, Child-Pugh score, and model for end-stage liver disease. In the subgroup analysis of cell numbers, all four of the indices were significantly improved when the number of BMSCs was >4 × 108. The subgroup analysis referring to the delivery route showed that arterial infusion increased the therapeutic effect over venous infusion. Finally, in the subgroup analysis of follow-up length, the results showed that BMSC therapy significantly improved liver function at 2 weeks after transplantation. In addition, this therapy improved coagulation 4 weeks after the transplant, with a maintenance of efficacy for up to 24 weeks.Conclusions: Autologous BMSC therapy is beneficial for liver improvement and coagulation in patients with liver cirrhosis. The therapeutic effect was generated at 2–4 weeks after transplantation. The effect lasted for 24 weeks but no more than 48 weeks. The greatest benefit to patients was observed with a 4 × 108 autologous BMSC transplant via the hepatic artery.

How Could We Slow or Reverse the Human Aging Process and Extend the Healthy Life Span with Heterochronous Autologous Hematopoietic Stem Cell Transplantation.

The senescence of the immune system contributes considerably to the age-related diseases that are the main causes of death after the age of 65. In this study, we present an appealing option for the prevention of immune senescence and slowing or reversing the aging process, which can be achieved by heterochronous autologous hematopoietic stem cell transplantation (haHSCT), where healthy autologous bone marrow stem cells are collected from donors while young, cryopreserved and stored for a long period, and reinfused at a later time when indicated. After reinfusion and homing, these young HSCs could participate in normal hemato- and immunopoiesis and improve several immune functions by expanding the immune- as well as hematopoietic cell repertoire. Several animal studies have already confirmed the feasibility of this procedure, which extended the longevity of the treated animals. If translated to human medicine, haHSCT could prevent or mitigate age-related immune defects and extend the healthy life span. In this review, we describe the concept of haHSCT, recent studies that confirm its feasibility, and discuss the further research needed to translate this heterochronous methodology.

Use of autologous mesenchymal stem cells in the combined treatment of symptomatic epilepsy

This article presents the results of the clinical application of the method of transplantation of autologous bone marrow stem cells in the treatment of a patient with pharmacoresistant epilepsy, the effectiveness of combination therapy, including antiepileptic drugs and autologous bone marrow stem cells and assess the feasibility, tolerability of this kind of local treatment. The encouraging results of the effectiveness of the proposed method of treatment of pharmacoresistant epilepsy on the clinical case of one patient have been obtained, which requires further study of the clinical application of the AMSC CM transplantation method on a more significant number of clinical cases in larger clinical trials.

Intracavernous application of autologous bone marrow stem cells for erectile dysfunction unresponsive to medical treatment: a clinical case

Background & Aim Stem cell therapy for erectile dysfunction is a field that has aroused the interest of the scientific society. Numerous preclinical studies have demonstrated the efficacy and safety of this therapeutic modality. However, the clinical experience of stem cells in erectile dysfunction remains very limited. We present a case of severe erectile dysfunction resistant to iPDE5, related to long-term diabetes mellitus treated with intracavernous stem cells. Methods, Results & Conclusion The intervention was intracavernous autologous bone marrow stem cell transplantation, in a single application. A 50-week follow-up was performed, evaluating the therapeutic response by means of several standardized clinical questionnaires, penile doppler ultrasound and the presence of adverse effects. Among the results obtained, we registered a maximum clinical response at week 12 of follow-up, which subsequently decreased progressively. Ultrasonographic findings revealed the presence of neovascularization emerging from the cavernous arteries at the end of follow-up. Although there is still insufficient evidence and standardization of therapeutic protocols, this result encourages future research of SCs as a possible therapeutic modality. Randomized clinical trials should be done in order to respond doubts regarding this procedure.

Efficacy of Different Doses of Human Autologous Adult Bone Marrow Stem Cell Transplantation on Angiogenesis in an Immune Deficient Rat Model with Hind Limb Ischemia

Efficacy of Different Doses of Human Autologous Adult Bone Marrow Stem Cell Transplantation on Angiogenesis in an Immune Deficient Rat Model with Hind Limb Ischemia

Autologous bone marrow stem cell therapy for patients undergoing coronary artery bypass grafting: A meta-analysis of 14 randomized controlled trials.

Autologous bone marrow stem cell (BMSC) therapy is a novel option for regenerative therapy in patients with ischemic heart disease. The aim of the present meta-analysis was to evaluate the effectiveness of BMSCs combined with coronary artery bypass grafting (CABG). The PubMed, Cochrane Library, EMBASE and Web of Science databases were searched from inception to November 22, 2017 for randomized controlled trials on BMSC therapy combined with CABG. Finally, 14 trials with a total of 596 participants were included. Data were analyzed using a random-effects model. Compared with the control group, the BMSC therapy group exhibited an improvement in the left ventricular (LV) ejection fraction from baseline to follow-up [mean difference (MD)=4.36%; 95% confidence interval (CI): 1.90–6.81%; P<0.01]. Analysis of the pooled results revealed non-significant differences in the LV end-diastolic volume (MD=−6.27 ml; 95% CI: −22.34 to 9.80 ml; P=0.44), LV end-diastolic volume index (MD=−15.11 ml/m2; 95% CI: −31.53 to 1.30 ml/m2; P=0.07), LV end-systolic volume (MD=−11.52 ml; 95% CI: −26.97 to 3.93 ml; P=0.14) and LV end-systolic volume index (MD=−16.56 ml/m2; 95% CI: −37.75 to 4.63 ml/m2; P=0.13) between the BMSC and CABG alone groups. Therefore, autologous BMSC therapy for patients undergoing CABG appears to be associated with an improvement in LV function compared with CABG alone.

Efficacy of Autologous Bone Marrow Mononuclear Cell Transplantation Therapy for Type 2 Diabetes Mellitus: An Updated Meta-Analysis

IntroductionStudies of the effects of stem cell therapy on type 2 diabetes mellitus (T2DM) have not reached consistent results. Our meta-analysis aimed to systematically evaluate the efficacy of autologous bone marrow-derived stem cells (ABM-MNCs) on T2DM.MethodsWe systematically searched PubMed, EMBASE, Web of Science, and the Cochrane Library for studies published between 1980 and May 2018. Two researchers screened the literature independently following the inclusion and exclusion criteria. Meta-analysis of the pooled standard mean difference (SMD) with 95% confidence interval (CI) was calculated based on either a fixed- or random-effects model.ResultsWe identified six studies with 206 participants investigating the effects of autologous bone marrow stem cell therapy on T2DM after screening 102 studies found after the initial search. According to the pooled estimates, compared with the control group, after 12-month follow-up the ABM-MNC therapy group had a lower level of HbA1c (MD, − 1.18; 95% CI, − 1.40 to 0.95) and lower required insulin dose (MD, − 2.05; 95% CI, − 3.55 to − 0.55). HbA1c decreased after ABM-MNC therapy compared with before (12 months: MD, − 1.22; 95% CI, − 1.43 to − 1.0). We also observed a significant decrease in insulin requirement after 3-, 6-, 9-, and 12-month follow-up in the ABM-MNC group, respectively.ConclusionAutologous stem cell therapy showed a beneficial effect on T2DM.

Отдаленные результаты операций изолированной трансмиокардиальной лазерной реваскуляризации в сочетании с интрамиокардиальным введением аутологичных стволовых клеток костного мозга

Введение. В настоящее время во всем мире активно внедряются альтернативные методы лечения ишемической болезни сердца (ИБС) и используются в ситуациях, когда не представляется возможным выполнить прямую реваскуляризацию миокарда. Среди них трансмиокардиальная лазерная реваскуляризация (ТМЛР), введение аутологичных стволовых клеток костного мозга (АСККМ). Чтобы достичь «синергизма» ТМЛР с интрамиокардиальным введением АСККМ, оба метода комбинировали.

Autologous Bone Marrow Stem Cell Transplantation in Liver Cirrhosis after Correcting Nutritional Anomalies, A Controlled Clinical Study.

Objective Liver transplantation is the gold standard approach for decompensated liver cirrhosis. In recent years, stem cell therapy has raised hopes that adjusting some clinical and laboratory parameters could lead to successful treatments for this disease. Cirrhotic patients may have multiple systemic abnormalities in peripheral blood and irregular cell populations in bone marrow (BM). Correcting these abnormalities before BM aspiration may improve the effectiveness of cell-based therapy of liver cirrhosis. Materials and Methods In this controlled clinical trial study, 20 patients with decompensated liver cirrhosis were enrolled. Patients were randomly assigned to control and experimental groups. Blood samples were obtained to measure vitamin B12, folate, serum iron, total iron bonding capacity (TIBC) and ferritin before any intervention. Furthermore, the iron storage and fibrosis level in BM biopsies, as well as the percentage of different cell populations, were evaluated. Prior to cell isolation for transplantation, we performed palliative supplement therapy followed by a correction of nutritional deficiencies. Mononuclear cells (MNCs) were then isolated from BM aspirates and transfused through peripheral vein in patients in the experimental group. The model of end-stage liver disease (MELD) score, The international normalized ratio (INR), serum albumin and bilirubin levels were assessed at 0 (baseline), 3 and 6 months after cell transplantation. Results The MELD score (P=0.0001), INR (P=0.012), bilirubin (P<0.0001) and total albumin (P<0.0001) levels improved significantly in the experimental group after cell transplantation compared to the baseline and control groups. Moreover, the increase in serum albumin levels of patients in the experimental group was statistically significant 6 months after transplantation. ConclusionWe have successfully improved the conditions of preparing -BM-derived stem cells for transplantation. Although these cells are relatively safe and have been shown to improve some clinical signs and symptoms temporarily, there need to be more basic studies regarding the preparation steps for effective clinical use (Registration number: IRCT2014091919217N1).

Avascular Necrosis of the Femoral Head in Sickle Cell Disease in Egypt and Oman: A Cross Sectional Study

BACKGROUND:Avascular necrosis (AVN) especially of the femoral head has long been recognized as a morbidity of sickle cell disease (SCD). AVN might be of gradual onset and silent or run a more acute course with severe pain and limping.The clinical presentations and risk factors of this complication among Egyptian and Omani children and young adults with SCD were not fully studied. We aimed to determine the patterns of presentation, risk factors, diagnosis and management of avascular necrosis of the hip in SCD in the 2 centers.PATIENTS AND METHODS: A cross sectional study carried out at the Pediatric Hematology clinics of Ain Shams and Sultan Qaboos University Hospitals. All young SCD patients diagnosed with hip AVN during the period between Jan. 2010-Jan. 2018 were included. Age of 1st presentation with SCD, symptoms or signs of AVN, frequency of VOCs, hospital admissions and transfusion, spleen status, hydroxyurea administration (dose and compliance ), radiological findings (X-ray and MRI using FICAT and Arlet Staging) and serum ferritin were recorded. Therapeutic options included physiotherapy, autologous bone marrow stem cell injection in the affected joint, hip coring, and hip replacement.RESULTS:Sixty-eight children, adolescents and young adults with SCD and AVN; aged 8-22 years of both sexes were recruited from two centers; Egypt; n= 22, and Oman; n= 46. Twenty patients (29.4%) had hemoglobin SS while 48 (70.6%) had Sickle-βThalassemia. Thirty-seven (54%), were males with a median age of 16 years, five out of the 22 Egyptians have in addition to hip AVN, femoral shaft necrosis in one patient and 2 have lumbar vertebra necrosis. According to FICAT and Alert classification of AVN; 22 patients had stage 0, 2 patients had stage I, 13 patients had stage II, 14 had stage III and 17 patients were at stage IV; 64% of patients had stage II and above at diagnosis. Sixty percent of the studied population were on Hydroxyurea; of them 25% were non-compliant. Multivariate regression analysis didn't show a significant risk factor for development of AVN in these patients. Management was different in the 2 centers; Half of the patients in Oman were managed with physiotherapy alone; while only 25% in Egypt. Stem cell injection in the bone marrow of the affected hip was tried in 25% of Omani patients with good success while none in the Egyptian patients. Hip replacement in was performed in a total of 7 patients and Bone marrow transplantation in two.CONCLUSION:Avascular necrosis of the hip is a significant cause of morbidity in SCD in this part of the world. Majority of patients had an advanced disease at diagnosis, which emphasizes the need of early screening to avoid complications of the advanced disease. Injection of bone marrow in the affected hip might be a promising tool to prevent disease progression and improve the symptoms. DisclosuresNo relevant conflicts of interest to declare.

Use of autologous bone marrow stem cell implantation for osteonecrosis of the knee in sickle cell disease: a preliminary report

BackgroundThe purpose of our study was to evaluate safety, feasibility and clinical results of bone marrow mononuclear cell (BMC) implantation for early-stage osteonecrosis of the knee (OK) secondary to sickle cell disease.MethodsThirty-three SCD patients (45 knees) with OK treated with BMC implantation in the osteonecrotic lesion were clinically and functionally evaluated through the American Knee Society Clinical Score (KSS), Knee Functional Score (KFS) and Numeric Rating Scale (NRS) pain score. MRI and radiographic examinations of the knee were assessed during a period of five years after intervention.ResultsNo complications or serious adverse event were associated with BMC implantation. From preoperative assessment to the latest follow-up, there was a significant (p < 0.001) improvement of clinical KSS (64.3 ± 9.7, range: 45–80 and 2.2 ± 4.1, range: 84–100, respectively), KFS (44.5 ± 8.0, range: 30–55 and 91.6 ± 5.8, range: 80–100, respectively) and reduction of NRS pain score (6.7 ± 1.2, range: 4–9 and 3.4 ± 1.0, range: 2–5, respectively). In total, 87% of patients (29/33) consistently experienced improvements in joint function and activity level as compared to preoperative score. No patient had additional surgery following BMC implantation. Radiographic assessment showed joint preservation and no progression to subchondral collapse at most recent follow-up.ConclusionsThe technique of BMC implantation is a promising, relatively simple and safe procedure for OK in SCD patients. Larger and long-term controlled trials are needed to support its clinical effectiveness.Trial registrationClinicalTrials.gov NCT02448121. Retrospectively registered 19 May 2015.

Clinical Safety and Efficacy of Autologous Bone Marrow-Derived Mesenchymal Stem Cell Transplantation in Sensorineural Hearing Loss Patients.

Stem cell transplantation represents a promising therapy for several degenerating and necrotic diseases. In several animal studies, we could find hearing restoration after inoculation of the mesenchymal stem cells' as well as mesenchymal stem cells' differentiation of hair cells and spiral ganglion. But until now, no clinical study has been reported directly for the human being. In this pilot studies, we applied mesenchymal stem cells to human beings trans-venously. Although we verified the safety of the autologous bone marrow stem cell transplantation in sensorineural hearing loss patients but we could not achieve significant improvement in hearing.

Характеристика костномозгового клеточного трасплантата больных хронической сердечной недостаточностью до и после кратковременной экспозиции с эритропоэтином

Аутологичные костномозговые стволовые клетки являются альтернативным способом терапии пациентов с сердечной недостаточностью. Цель работы - изучение фенотипа и функциональных свойств костномозговых мононуклеарных клеток (КМ-МНК) больных хронической сердечной недостаточностью (ХСН) до и после кратковременной экспозиции с эритропоэтином in vitro . Методика. КМ-МНК выделяли на градиенте плотности фиколл/верографин (r = 1,077 г/л). Фенотип КМ-МНК, клеточный цикл и апоптоз CD34+ клеток определяли до и после экспозиции с эритропоэтином на проточном цитометре. Пролиферативный потенциал КМ-МНК до и после экспозиции с эритропоэтином оценивали в спонтанном и стимулирующем тесте. Пролиферацию, миграцию и ангиогенный потенциал клеток EA.hy 929 изучали в тесте «раневого дефекта» монослоя клеток и на матригеле под влиянием 30% кондиционных сред от КМ-МНК. Результаты. Показано, что КМ-МНК представляют собой смесь гемопоэтических стволовых клеток (ГСК), эндотелиальных прогениторных клеток (ЭПК) на разных этапах созревания и дифференцировки, и мезенхимных стволовых клеток (МСК). Под действием эритропоэтина увеличивается количество CD34+ клеток в G0G1 фазе клеточного цикла, CD45+/EpoR+, CD31-/CD184+, CD31+/CD184+ и CD34+/CD184-, и уменьшается количество CD34+/CD133+, CD34+/EpoR-. Кондиционная среда от КМ-МНК способствует пролиферации, миграции и формированию сосудисто-подобных структур клетками EA.hy 929. Заключение. Полученные результаты свидетельствуют, что кратковременная экспозиция КМ-МНК больных ХСН задерживает CD34+ клетки в стадии покоя, увеличивает пул ЭПК, экспрессирующих «хоуминг» рецептор, а кондиционная среда от КМ-МНК стимулирует пролиферацию, миграцию и ангиогенный потенциал EA.hy 929, что следует учитывать при выборе методов усиления «приживаемости» клеточного трансплантата. Autologous bone marrow stem cells are an alternative therapy for patients with heart failure. The aim of this work was to study the phenotype and functional properties of bone marrow mononuclear cells (BM-MNCs) from patients with chronic heart failure (CHF) before and after a short-term in vitro exposure to erythropoietin. Methods. BM-MNCs were isolated using density gradient. The BM-MNC phenotype, cell cycle, and apoptosis of CD34+ cells were evaluated before and after exposure to erythropoietin with a flow cytometer. Proliferation of BM-MNCs before and after the erythropoietin exposure was evaluated in a spontaneous and stimulating test. Proliferation, migration, and angiogenic potential of EA.hy 929 cells were studied in the wound closure test and in the tubule formation test under the influence of 30% conditioned medium from BM-MNCs. Results. BM-MNCs represented a mixture of hematopoietic stem cells (HSCs), endothelial progenitor cells (EPCs) at different stages of maturation and differentiation, and mesenchymal stem cells (MSCs). Erythropoietin increased the number of CD34+ cells in the G0/G1 cell cycle phase, CD45+/EpoR+, CD31-/CD184+, CD31+/CD184+, and CD34+/CD184-, and decreased the number of CD34+/CD133+ and CD34+/EpoR. The erythropoietin exposure of BM-MNCs reduced their proliferative capacity. The BM-MNCs-conditioned medium promoted EA.hy 929 cell proliferation, migration, and formation of vascular-like structures. Conclusion. A short-term exposure of BM-MNCs delayed the resting stage of CD34+ cells, increased the pool of EPCs expressing the homing receptor while the BM-MNC conditioned medium stimulated EA.hy 929 proliferation, migration and tubule formation, which should be taken into account when selecting methods to enhance survival of cellular grafts.

Autologous bone marrow stem cell therapy in patients with ST-elevation myocardial infarction: a systematic review and meta-analysis

Abstract Background Randomized controlled trials (RCTs) on bone marrow stem cell (BMSC) therapy in ST-elevation myocardial infarction (STEMI) patients have reported conflicting results. Our main objective was to critically appraise and meta-analyze best-available evidence on efficacy and safety of intracoronary administration of autologous BMSC therapy in STEMI patients after primary percutaneous coronary intervention. Methods We conducted a search of MEDLINE, PubMed, EMBASE, CENTRAL, Global Health, CINAHL, and conference proceedings in February 2017. Our primary outcome was all-cause mortality. Secondary and safety outcomes included cardiac death, heart failure, arrhythmias, repeat myocardial infarction, or target vessel revascularizations; or improved health-related quality of life, left ventricular ejection fraction, or infarct size. Summary relative and absolute risks were obtained using random effects models. We also evaluated the strength of evidence. Results A comprehensive database search identified 42 RCTs (3365 STEMI patients). BMSC therapy did not significantly decrease mortality (risk ratio, 0.71; 95% confidence interval, 0.45-1.11; I 2 , 0%; absolute risk reduction, 0.1%; 95% confidence interval, −0.71 to 0.91; 40 trials; 3289 participants; I 2 , 0%; low strength of evidence). BMSC therapy had no effect on secondary or adverse outcomes. Trial sequential analysis for all-cause mortality showed no evidence of a clinically important difference, with a very low probability that future studies can change the current conclusion. Conclusions On the basis of evidence from 42 RCTs published in the past 15 years, we provide conclusive evidence for a lack of beneficial effect for autologous BMSC therapy in patients with STEMI.

ASCOT: Autologous Bone Marrow Stem Cell Use for Osteoarthritis of the Thumb-First Carpometacarpal Joint.

Background:The first carpometacarpal joint (CMCJ) in the hand is a commonly affected joint by osteoarthritis. It causes significant thumb base pain, limiting functional capacity. Microfracturing and application of autologous stem cells has been performed on large joints such as the knee but has never been evaluated for use in the smaller joints in the hand. Our aim was to determine the potential benefit of microfracturing and autologous bone marrow stem cells for treatment of osteoarthritis of the first CMCJ in the hand.Methods:All inclusion criteria were satisfied. Preoperative assessment by the surgeon, physiotherapist, and occupational therapist was performed. The first CMCJ was microfractured and the Bone Marrow Stem Cells were applied directly. Postoperatively, the patients were followed up for 1 year.Results:Fifteen patients met inclusion criteria; however, 2 patients were excluded due to postoperative cellulitis and diagnosis of De Quervain's tenosynovitis. The mean scores of the 13-patient preoperative and 1 year follow-up assessments are visual analog score at rest of 3.23–1.69 (P = 0.0292), visual analog score on activity of 7.92–4.23 (P = 0.0019), range of motion 45.77o–55.15o (P = 0.0195), thumb opposition score 7.62–9.23 (P = 0.0154), Disability of the Arm, Shoulder and Hand score of 51.67–23.08 (P = 0.0065). Strength improved insignificantly from 4.7 kg preoperatively to 5.53 kg at 12 months (P = 0.1257). All patients had a positive Grind test preoperatively and a negative test after 12 months.Conclusions:This innovative pilot study is a new approach to osteoarthritis of the thumb.

Multi-modality imaging in the patients with myocardial infarction after coronary artery bypass graft and autologous bone marrow stem cell transplantation

Objective To evaluate the value of multi-modality imaging (PET/CT+ CAG+ CMRI) in post myocardial infract (MI) patients followed coronary artery bypass graft (CABG) and autologous bone marrow stem cell (BMSC) therapy. Methods A total of 43 patients with MI (27 males, 16 females, age range: 47-72 years) were prospectively enrolled in the year 2012 between January and December. All patients underwent CABG+ BMSC transplantation and were divided into 3 groups according to the time interval between two treatments (group 1: 0-3 d; group 2: 4-14 d; group 3: 15-30 d). All patients were orderly scanned with CMRI, PET/CT (13N-NH3·H2O/18F-FDG) and CAG at different time-points pre-/post- treatment. The quantitative parameters included vascular stenosis degree(VSD), LVEF, percentage size of infarction (PSI), the number of segments in mismatched myocardial perfusion/metabolic and the K value for radioactive distribution grading. One-way analysis of variance and the least significant difference t test were used to compare parameters before and after treatment in the same group and among three different groups. Results Regarding PET/CT diagnostic efficacy of abnormal myocardial segments, the sensitivity, specificity, positive predictive value and negative predictive value were 95.4%(540/566), 87.3%(144/165), 96.3%(540/561) and 84.7%(144/170), respectively. After CABG and BMSC transplantation treatments for 12 months, VSD decreased significantly((69.1±9.5)%; F=12.854, P 0.05). PSI of patients in group 2 decreased greatly after 12 months treatment ((35.70±12.59)%; F=3.792, t values: -2.916-4.059, all P 0.05). Conclusions Multi-modality imaging may be used for accurately detecting abnormal myocardium and predicting prognosis. CABG+ BMSC therapy during day 4-14 post-MI may temporarily improve perfusion and metabolism in viable myocardium, but the long term prognosis seemed not be improved. Key words: Myocardial infarction; Stem cell transplantation; Transplantation, autologous; Coronary artery bypass; Position-emission tomography; Tomography, X-ray computed; Coronary angiography; Magnetic resonance imaging

The immediate results of simultaneous surgical correction of complex heart disease with concomitant atrial fibrillation immediate effects of isolated transmyocardial laser revascularization procedures combined with intramyocardial injection of autologous bone marrow stem cells in patients with terminal stage of coronary artery disease

The immediate results of simultaneous surgical correction of complex heart disease with concomitant atrial fibrillation immediate effects of isolated transmyocardial laser revascularization procedures combined with intramyocardial injection of autologous bone marrow stem cells in patients with terminal stage of coronary artery disease

Abstract 65: ASCOT- Autologous use of bone marrow derived Stem Cells for Osteoarthritis of the Thumb-1st CMCJ

PURPOSE: The 1st Carpometacarpal Joint (CMCJ) in the hand is a commonly affected joint by Osteoarthritis (OA). It causes significant thumb base pain, limiting functional capacity. Surgical techniques are fraught with complications. Conservative management slows disease progression but does not reverse pre-existing damage. Microfracturing and application of Autologous Stem Cells has been performed on large joints such as the knee but has never been evaluated for use in the smaller joints in the hand. Our aim is to determine the potential benefit of Autologous Bone Marrow Stem Cells (BMSC) for treatment of osteoarthritis of the 1stCMCJ in the hand. METHODS: All inclusion criteria were satisfied and patients were consented. Pre-operative assessment by the surgeon, Physiotherapist (PT) and Occupational Therapist (OT) was performed. Intra-operatively, BMSC were isolated from the hip via BMAC. The 1st CMCJ was opened and the joint surface microfractured. The BMSC were applied directly to the microfractured articular surface. Post-operatively the patients were followed up at regular intervals by the same surgeon, PT and OT. The assessments performed included: the visual analogue score (VAS) at rest and with activity, range of motion (ROM) in palmar abduction, functional DASH, strength test by lateral pinch, kapandji opposition score and the Grind Test. Statistical analysis was done using Prism Software, comparing preoperative scores and scores 6 months later using a paired T-test. RESULTS: All patients had a positive Grind test preoperatively and a negative test after 6 months. Statistically significant improvements were seen (Means scores with P values) VAS at rest 3.25 to 1.425 (P=0.0138), VAS on activity 7.7 to 3.9 (P=0.0021), ROM 46o to 53o (P= 0.0095) and DASH 47.23 to 18.7 (P=0.0046). Strength and Kapandji score improved insignificantly at 6 months. There were no significant postoperative complications. Patients were satisfied with the procedure. CONCLUSIONS: This innovative pilot study is a new approach to OA of the thumb. It is a safe procedure with no post op complications. ASCOT 2 will be designed to determine the exact role of BMSC in this procedure with a control group receiving microfracture alone.

Autologous Stem Cells Combined Core Decompression for Treatment of Avascular Necrosis of the Femoral Head: A Systematic Meta-Analysis.

Objective This study aims to systematically evaluate the efficacy and safety of core decompression combined transplantation of autologous bone marrow stem cells (CDBMSCs) for treatment of avascular necrosis of the femoral head (ANFH). Methods Randomized controlled trials (RCTs) regarding effectiveness of core decompression combined transplantation of autologous bone marrow stem cells for treating ANFH were searched in 8 comprehensive databases prior to September 2016. The data analysis was performed by using the RevMan version 5.3. Results A total of 11 studies with 507 participants were included. Results showed that CDBMSCs group was more effective than CD group in increasing Harris hip score, decreasing necrotic area of femoral head, collapse of femoral head, and conversion to total hip replacement incidence. In the subgroup analysis, the results did not change in different intervention measure substantially. In addition, the safety of CDBMSCs for ANFH is reliable. Conclusion Based on the systematic review, our findings suggest that core decompression combined transplantation of autologous bone marrow stem cells appeared to be more efficacious in the treatment at early stages of ANFH.

CORRECTION: Autologous Bone Marrow Stem Cells combined with Allograft Cancellous Bone in Treatment of Nonunion

Page 417, Acknowledgments section, the text “We acknowledge colleagues at Center. of Haematology, Hue Central Hospital. I special thanks to Dr. PHAN Thi Thuy Hoa, Dr. PHAN Hoang Duy, and Dr. Paul LUU for their excellent support. I also thank you Dr. NGUYEN Van Hoa from Hue University of Medicine and Pharmacy for the help in statistical analysis.” Should read “We acknowledge colleagues at Center. of Haematology, Hue Central Hospital. I special thanks to Dr. PHAN Thi Thuy Hoa, Dr. PHAN Hoang Duy, and Dr. Paul LUU for their excellent support. I also thank you Dr. NGUYEN Van Hoa from Hue University of Medicine and Pharmacy for the help in statistical analysis. This work was sponsored by Thua Thien - Hue Foundation for Science and Technology Development (TTH.2014-KC.16)”.