Autologous bone-marrow mononuclear stem cell therapy in patients with stroke: a meta-analysis of comparative studies
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RESEARCH
Autologous bone‑marrow mononuclear stem cell therapy in patients with stroke: a meta‑analysis of comparative studies Sorayouth Chumnanvej1 and Siriluk Chumnanvej2* *Correspondence: [email protected] 2 Department of Anesthesiology and Operating Room, Phramongkutklao Hospital, Bangkok, Thailand Full list of author information is available at the end of the article
Abstract Background: There is a need to promote recovery after stroke with novel therapeutic interventions. Of them, bone-marrow mononuclear cell (BM-MNC) therapy offers promising outcomes in preclinical and clinical models. Aims: To investigate the efficacy and safety of BM-MNCs versus traditional medical care of stroke patients. Summary of review: A meta-analysis was conducted involving controlled prospective studies and randomized clinical trials (RCTs) which investigated the changes in the scores of neurological functions (the National Institutes of Health Stroke Scale [NIHSS]), the indices of functional recovery (the Barthel Index [BI] and the modified Rankin scale [mRS]) at 3 and 6 month post-transplantation. A total of nine studies (five RCTs) recruited 469 stroke patients (65.5% males, 49.25% received the intervention). There were no significant differences in NIHSS, BI, or mRS scores after 3 months of follow-up. However, the BI indices of BM-MNCs-receiving patients improved significantly after 6 months (standardized mean difference = 1.17, 95% confidence interval, 0.23 to 2.10, P = 0.01) as compared to traditional treatment. The risk of mortality and adverse events and the proportion of patients with favorable outcomes (mRS ≤ 3) were similar in both groups. Conclusion: Both the BM-MNCs and medical stroke treatment have similar outcomes in terms of safety and short-term efficacy, while the effect of therapy is significant only after 6 months. More well-designed, large sized RCTs are needed to confirm the efficacy of stem cell therapy over long periods of follow-up. Keywords: Stem cells, Mesenchymal stem cell transplantation, Stroke, Bone marrow, Random allocation
Background Stroke is an acute life-threatening neurologic disorder which comprises of rupture or occlusion of brain blood vessels. Ischemic stroke incidents represent the majority of cases (87%), and the rest are hemorrhagic. Globally, the disease accounted for approximately 5.5 million deaths and 116.4 million disability-adjusted life-years in 2016, 80% of whom were reported in low- and middle-income countries [1]. Besides, about 795,000 © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated
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