Safety of cell therapy with mesenchymal stromal cells (SafeCell): a systematic review and meta-analysis of clinical trials.

<h4>Background</h4>Mesenchymal stromal cells (MSCs, "adult stem cells") have been widely used experimentally in a variety of clinical contexts. There is interest in using these cells in critical illness, however, the safety profile of these cells is not well known. We thus cond...

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Autores principales: Manoj M Lalu, Lauralyn McIntyre, Christina Pugliese, Dean Fergusson, Brent W Winston, John C Marshall, John Granton, Duncan J Stewart, Canadian Critical Care Trials Group
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Publicado: Public Library of Science (PLoS) 2012
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spelling oai:doaj.org-article:b8655dd2afe54445977d83005acb0f1c2021-11-18T08:11:02ZSafety of cell therapy with mesenchymal stromal cells (SafeCell): a systematic review and meta-analysis of clinical trials.1932-620310.1371/journal.pone.0047559https://doaj.org/article/b8655dd2afe54445977d83005acb0f1c2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23133515/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Mesenchymal stromal cells (MSCs, "adult stem cells") have been widely used experimentally in a variety of clinical contexts. There is interest in using these cells in critical illness, however, the safety profile of these cells is not well known. We thus conducted a systematic review of clinical trials that examined the use MSCs to evaluate their safety.<h4>Methods and findings</h4>MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (to June 2011), were searched. Prospective clinical trials that used intravascular delivery of MSCs (intravenously or intra-arterially) in adult populations or mixed adult and pediatric populations were identified. Studies using differentiated MSCs or additional cell types were excluded. The primary outcome adverse events were grouped according to immediate events (acute infusional toxicity, fever), organ system complications, infection, and longer term adverse events (death, malignancy). 2347 citations were reviewed and 36 studies met inclusion criteria. A total of 1012 participants with clinical conditions of ischemic stroke, Crohn's disease, cardiomyopathy, myocardial infarction, graft versus host disease, and healthy volunteers were included. Eight studies were randomized control trials (RCTs) and enrolled 321 participants. Meta-analysis of the RCTs did not detect an association between acute infusional toxicity, organ system complications, infection, death or malignancy. There was a significant association between MSCs and transient fever.<h4>Conclusions</h4>Based on the current clinical trials, MSC therapy appears safe. However, further larger scale controlled clinical trials with rigorous reporting of adverse events are required to further define the safety profile of MSCs.Manoj M LaluLauralyn McIntyreChristina PuglieseDean FergussonBrent W WinstonJohn C MarshallJohn GrantonDuncan J StewartCanadian Critical Care Trials GroupPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 10, p e47559 (2012)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Manoj M Lalu
Lauralyn McIntyre
Christina Pugliese
Dean Fergusson
Brent W Winston
John C Marshall
John Granton
Duncan J Stewart
Canadian Critical Care Trials Group
Safety of cell therapy with mesenchymal stromal cells (SafeCell): a systematic review and meta-analysis of clinical trials.
description <h4>Background</h4>Mesenchymal stromal cells (MSCs, "adult stem cells") have been widely used experimentally in a variety of clinical contexts. There is interest in using these cells in critical illness, however, the safety profile of these cells is not well known. We thus conducted a systematic review of clinical trials that examined the use MSCs to evaluate their safety.<h4>Methods and findings</h4>MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (to June 2011), were searched. Prospective clinical trials that used intravascular delivery of MSCs (intravenously or intra-arterially) in adult populations or mixed adult and pediatric populations were identified. Studies using differentiated MSCs or additional cell types were excluded. The primary outcome adverse events were grouped according to immediate events (acute infusional toxicity, fever), organ system complications, infection, and longer term adverse events (death, malignancy). 2347 citations were reviewed and 36 studies met inclusion criteria. A total of 1012 participants with clinical conditions of ischemic stroke, Crohn's disease, cardiomyopathy, myocardial infarction, graft versus host disease, and healthy volunteers were included. Eight studies were randomized control trials (RCTs) and enrolled 321 participants. Meta-analysis of the RCTs did not detect an association between acute infusional toxicity, organ system complications, infection, death or malignancy. There was a significant association between MSCs and transient fever.<h4>Conclusions</h4>Based on the current clinical trials, MSC therapy appears safe. However, further larger scale controlled clinical trials with rigorous reporting of adverse events are required to further define the safety profile of MSCs.
format article
author Manoj M Lalu
Lauralyn McIntyre
Christina Pugliese
Dean Fergusson
Brent W Winston
John C Marshall
John Granton
Duncan J Stewart
Canadian Critical Care Trials Group
author_facet Manoj M Lalu
Lauralyn McIntyre
Christina Pugliese
Dean Fergusson
Brent W Winston
John C Marshall
John Granton
Duncan J Stewart
Canadian Critical Care Trials Group
author_sort Manoj M Lalu
title Safety of cell therapy with mesenchymal stromal cells (SafeCell): a systematic review and meta-analysis of clinical trials.
title_short Safety of cell therapy with mesenchymal stromal cells (SafeCell): a systematic review and meta-analysis of clinical trials.
title_full Safety of cell therapy with mesenchymal stromal cells (SafeCell): a systematic review and meta-analysis of clinical trials.
title_fullStr Safety of cell therapy with mesenchymal stromal cells (SafeCell): a systematic review and meta-analysis of clinical trials.
title_full_unstemmed Safety of cell therapy with mesenchymal stromal cells (SafeCell): a systematic review and meta-analysis of clinical trials.
title_sort safety of cell therapy with mesenchymal stromal cells (safecell): a systematic review and meta-analysis of clinical trials.
publisher Public Library of Science (PLoS)
publishDate 2012
url https://doaj.org/article/b8655dd2afe54445977d83005acb0f1c
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