title: Bone Marrow Therapies for Chronic Heart Disease.
abstract: Chronic heart failure is a leading cause of death. The demand for new therapies and the potential regenerative capacity of bone marrow-derived cells has led to numerous clinical trials. We critically discuss current knowledge of the biology and clinical application of bone marrow cells. It appears unlikely that bone marrow cells can develop into functional cardiomyocyte after infusion but may have favorable paracrine effects. Most, but not all, clinical trials report a modest short- but not long-term benefit of infusing bone marrow-derived cells. Effect size appears to correlate with stringency of study-design: the most stringent trials report the smallest effect-sizes. We conclude there may be short- but not substantial long-term benefit of infusing bone marrow-derived cells into persons with chronic heart failure and any benefit observed is unlikely to result from trans-differentiation of bone marrow-derived cells into functioning cardiomyocytes.
authors.affiliation: Clinical Observer, Division of Hematology, Stanford MDS Center, Stanford University, Palo Alto, California, USA.
authors.forename: Iman Saramipoor
authors.initials: IS
authors.lastname: Behbahan
authors.affiliation: Division of Hematology, University of Toronto, Cell Therapy Program, Princess Margaret Hospital, Toronto, Canada.
authors.forename: Armand
authors.initials: A
authors.lastname: Keating
authors.affiliation: Section of Haematology, Division of Medicine, Department of Medicine, Imperial College London, London, United Kingdom.
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Gale
mesh_terms: D000818:Animals; D001854:Bone Marrow Cells / Q000502:physiology*; D016026:Bone Marrow Transplantation / Q000379:methods* / Q000639:trends; D002454:Cell Differentiation / Q000502:physiology; D002908:Chronic Disease; D002986:Clinical Trials as Topic / Q000379:methods; D006331:Heart Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D032383:Myocytes, Cardiac / Q000502:physiology; D012038:Regeneration / Q000502:physiology*
keywords: Cell transplantation; Chronic heart disease; Hematopoietic cell transplantation; Hematopoietic cells