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Stem cell treatment for acute myocardial infarction. Cochrane Database Syst Rev. 2008;(4):CD006536 Authors: Martin-Rendon E, Brunskill S, Dorée C, Hyde C, Watt S, Mathur A, Stanworth S BACKGROUND: Stem cell therapy offers a promising approach to the regeneration of damaged vascular and cardiac tissue after myocardial infarction (MI). This has resulted in multiple randomised controlled trials (RCTs) worldwide. OBJECTIVES: To critically evaluate evidence from RCTs on the effectiveness of adult bone marrow-derived stem cells (BMSC) to treat acute MI. SEARCH STRATEGY: MEDLINE (1950 to August 2007), EMBASE (1974 to August 2007), The Cochrane Library (Issue 3 2007), and CINAHL (1982 to August 2007) were searched. In addition LILACS, KOREAMED, INMED, Current Controlled Trials Register, the UK National Research Register and other handsearching was undertaken to August 2007. SELECTION CRITERIA: RCTs comparing autologous stem/progenitor cells with no autologous stem/progenitor cells in patients diagnosed with acute myocardial infarction (AMI) were eligible. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened all references, assessed trial quality and extracted data. Meta-analyses using a random-effects model were conducted and heterogeneity was explored using sub-group analyses. MAIN RESULTS: Thirteen RCTs (811 participants) were included. There were insufficient events on clinical outcomes like mortality to draw clear conclusions. Stem/progenitor cell treatment does not appear to be associated with an increase in adverse events but again the data do not allow clear conclusions. Left ventricular ejection fraction (LVEF) was the outcome with most results and there was marked heterogeneity between trials. There was however a consistent pattern indicating that BMSC treatment generally improves short-term LVEF, with similar trends for left ventricular end systolic and end diastolic volumes (LVESV and LVEDV), infarct size or cardiac wall motion. There was a positive correlation between cell dose infused and the effect on LVEF measured by magnetic resonance imaging. AUTHORS' CONCLUSIONS: The results of this systematic review suggest that there is little evidence to assess the clinical effects of this treatment. Larger trials using optimal dosing and more reliable, patient-centred outcomes are required. Several trials are ongoing but is unclear whether these will overcome the limitations of the current evidence base. PMID: 18843721 [PubMed - indexed for MEDLINE]

Stem cell treatment for Crohn's disease. Expert Rev Clin Immunol. 2010 Jul;6(4):597-605 Authors: Panés J, Ordás I, Ricart E While stem cell-based treatments have been established as a clinical standard of care for some conditions, such as hematopoietic stem cell transplants for cancer, the scope of potential stem cell-based therapies has expanded in recent years due to advances in stem cell research, paving the way for the increasing utilization of stem cell therapies in severe immune-mediated diseases including inflammatory bowel diseases (IBDs) and, in particular, Crohn's disease. Both hematopoietic stem cells and mesenchymal (stromal) stem cells are considered to be of potential therapeutic benefit in immune-mediated conditions. A growing body of experimental and clinical evidence shows that hematopoietic stem cell transplant induces long-lasting remission in a majority of patients with active severe Crohn's disease refractory to drug treatments, and the differential effect of potent immunosuppression and immune reconstitution in this setting is under evaluation. Mesenchymal stem cells have been shown to exert immunomodulatory action on various types of immune-mediated diseases, and in experimental models of IBD, but evaluation of the potential efficacy of this therapy in IBD is still in the early stages. PMID: 20594133 [PubMed - indexed for MEDLINE]

Celgene Cellular Therapeutics (CCT), a branch of Celgene Corporation (NASDAQ: CELG), announced recently the development of a clinical application of stem cells derived from human placenta (HPDSCs) for use in hematopoietic reconstitution therapies. This important hallmark in the road to achieve therapeutic use of human plancenta stem cells occurred at the LSU Health Sciences Center Children’s Hospital (LSU) on March 28, 2008. The transplant was scheduled to treat a pediatric patient with Acute Lymphoblastic Leukemia (ALL). This is a cancer of the bone marrow and blood. When the patient’s sibling was born in December 2007, human placental stem cells, along with cord blood, were collected and cryo-preserved and both products were used in the transplant.

CCT employs proprietary technologies for collecting, processing, and storing human plancenta-derived stem cells. This versatile kind of stem cells have a strong potential for developing therapeutic applications in, for example, leukemia and other hematological malignancies, solid tumor cancers, and autoimmune diseases. The company is also conducting research on other types of stem cells derived from the placenta that are obtained via additional proprietary methodologies.

The transplant, which is part of a multicenter clinical trial being conducted at LSU, together with other institutions, is using stem cells from placenta for patients with certain disorders including cancers and non-malignancies. The primary goal of theis study is to assess the safety of transplantation of umbilical cord blood boosted with placental stem cells from the same donor, There is also a secondary objective, which is assessing potential restoration of normal hematopoiesis and immune function with this combination of cells. The plan of the trial includes careful monitoring post-transplant for up to 24 months to monitor safety outcomes, engraftment, and survival.

“The patient is doing extremely well and, in fact, was discharged from the hospital one-to-two weeks earlier compared to traditional cord blood transplants,” said Lolie C. Yu, M.D., Professor of Pediatrics, Division Chief of the Pediatric Heme-Onc Program, Director of the BMT Program at LSUHSC/Children’s Hospital. “Neutrophil engraftment occurred earlier than anticipated in this proof-of-principle study further raising our hopes regarding the benefits of this treatment.”

Numerous professionals agree that there is considerable anticipation around the potential of placental stem cells. Another study by researchers from UCLA published earlier this year declared that blood-forming stem cells originate in the placenta in laboratory animals.

“We are excited to advance our study of the placenta as a source of stem cells that have the ability to effectively treat patients worldwide,” said Robert Hariri, M.D., Ph.D., CEO of Celgene Cellular Therapeutics. “We are pleased with this first positive step in our effort to bring this cutting-edge therapy to the clinic to treat sufferers with a variety of devastating diseases.”

“For the first time, we are transplanting human placenta-derived stem cells to treat patients with a variety of cancers and non-malignant diseases,” said Mitchell Cairo, M.D., who leads the clinical trial at Morgan Stanley Children’s Hospital and Columbia University Medical Center, and is Chief of the Pediatric Blood and Marrow Transplantation Division at Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Professor of Pediatrics, Medicine and Pathology at Columbia University College of Physicians and Surgeons. “Our hope is that HPDSCs, in conjunction with cord blood stem cells, will expedite engraftment and improve treatment for patients.”