Effectiveness and Safety of Autologous Bone Marrow Stromal Cells Transplantation After Ischemic Stroke: A Meta-Analysis
Wenying Cao, Pan Li
(Department of Neurology, The Ninth People’s Hospital of Chongqing, Chongqing, China (mainland))
Med Sci Monit 2015; 21:2190-2195
Autologous bone marrow stromal cells (BM-SCs) transplantation might be a potential therapy for stroke. Although a series of clinical trials were performed to assess the effectiveness and safety of BM-SCs transplantation after ischemic stroke, the results are still conflicting. This study aimed to pool previous controlled trials to assess the effectiveness of BM-SCs-based cell therapy after ischemic stroke.
MATERIAL AND METHODS: Relevant studies were searched among online databases. Barthel index (BI) or modified Barthel index (mBI), National Institutes of Health Stroke Scale (NIHSS), and Rankin Score (mRS) were used to assess therapeutic effects. The frequencies of adverse events were extracted for assessing safety of stem cell therapy. Data analysis was performed by using Review Manager 5.3.
RESULTS: Patients who received cell therapy had significantly lower NIHSS score (–1.85) than the controls. In addition, there might be some benefits in daily activity measured by mBI, but this meta-analysis failed to demonstrate significant benefits of BM-SCs-based cell therapy in increasing the proportion of mRS ≤2 patients. We did not find any severe adverse events associated with BM-SCs-based cell therapy.
CONCLUSIONS: Although BM-MNCs/MSCs transplantation might generate some benefits in lowering the grade of impairment caused by ischemic stroke, large RCTs are required to further confirm the effectiveness of BM-MSCs/MNCs-based cell therapy and to optimize the conditions require for best therapeutic effects.
Keywords: Bone Marrow Transplantation - methods, Brain Ischemia - therapy, Humans, Stroke - therapy, Stromal Cells - transplantation, Transplantation, Autologous, Treatment Outcome