Bone Marrow Cell Therapy: Emerging Clinical Evidence

Numerous clinical trials of bone marrow cell (BMC) therapy for heart repair have been completed over the past 15 years. These early trials included relatively small numbers of patients and injected widely variable numbers of BMCs using different routes at various time-points after myocardial infarction (MI). Consistently, the outcomes of BMC therapy in these trials have been discordant. In order to synthesize evidence, pooled data from these studies have been subjected to numerous meta-analyses over the past decade. Although these meta-analyses included diverse combinations of trials and patient types, the results broadly indicate that BMC therapy is safe and produces modest improvements in cardiac parameters in patients with acute MI and chronic IHD. Importantly, these analyses also identify significant benefits of BMC therapy with regard to key clinical outcomes during follow-up. However, a number of major challenges still remain to be overcome in order to harness the full potential of such therapy in clinical practice. The purpose of this talk is to summarize the emerging clinical evidence regarding the efficacy and safety of cardiac repair with adult BMCs, and to discuss insights from meta-analyses.