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Review
. 2019 May 20;10(1):137.
doi: 10.1186/s13287-019-1238-5.

Safety and efficacy of bone marrow-derived cells therapy on cardiomyopathy: a meta-analysis

Chao Wang  1 , Jingzhao Li  2 , Boya Zhang  2 , Yongjian Li  2
Affiliations
Review

Safety and efficacy of bone marrow-derived cells therapy on cardiomyopathy: a meta-analysis

Chao Wang et al. Stem Cell Res Ther. .

Abstract

Background: Controversial results still existed on the clinical utility of bone marrow-derived cells (BMCs) for cardiomyopathy (CMP). This study aims to reveal the true power of this promising approach by synthesizing all the available data on this subject matter.

Methods: Twenty studies including 1418 patients were identified from systematic search. Weighted mean differences for changes in left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), 6-min walk distance, and NYHA functional class were estimated with a random-effects model. Major adverse cardiovascular event (MACE), rehospitalization, all-cause mortality, and patients' quality of life were also calculated.

Results: Compared with the control group, BMC therapy resulted in greater LVEF (3.72%, 95% CI 2.31 to 5.13, P < 0.0001), 6-min walk distance (53.16, 95% CI 25.17 to 81.10, P = 0.0002), NYHA functional class (- 0.48, 95% CI - 0.65 to - 0.31, P < 0.0001), and smaller LVESV (- 16.79, 95% CI - 27.21 to - 6.38, P = 0.002). BMC treatment significantly reduced the mortality rate and improved patients' quality of life. No significant difference was found between the BMCs and control group in LVEDV, MACE, and rehospitalization rate. However, the outcomes showed a clear trend in favor of the BMC group. Subgroup analysis showed that LVEF improved greater in a subgroup of intracoronary infusion, BMSC, or higher cell dose.

Conclusion: The results of the current meta-analysis suggest that BMC treatment for CMP is safe and feasible. This therapy was associated with persistent improvements in LV function, LV remodeling, functional class, patients' survival, and quality of life. Intracoronary infusion of high-dose (> 108) BMSC might be a better therapeutic option for CMP patients. Further evidences are needed to verify our results.

Keywords: Bone marrow cells; Cardiomyopathy; Ventricular function; Ventricular remodeling.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the literature search in this meta-analysis
Fig. 2
Fig. 2
Risk of bias summary of 22 included studies
Fig. 3
Fig. 3
Forest plot of pooled left ventricular ejection fraction (LVEF) with bone marrow-derived cell treatment compared with the control group
Fig. 4
Fig. 4
Forest plot of pooled left ventricular end-systolic volume (LVESV) with bone marrow-derived cell treatment compared with the control group
Fig. 5
Fig. 5
Forest plot of pooled left ventricular end-diastolic volume (LVEDV) with bone marrow-derived cell treatment compared with the control group
See this image and copyright information in PMC

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