title: Bone marrow mononuclear cell therapy in ischaemic stroke: a systematic review.
abstract: Bone marrow mononuclear cell (BM-MNC) therapy has emerged as a potential therapy for the treatment of stroke. We performed a systematic review of published studies using BM-MNC therapy in patients with ischaemic stroke (IS). Literature was searched using MEDLINE, PubMed, EMBASE, Trip Database, Cochrane library and clinicaltrial.gov to identify studies on BM-MNC therapy in IS till June, 2016. Data were extracted independently by two reviewers. STATA version 13 was used for carrying out meta-analysis. We included non-randomized open-label, single-arm and non-randomized comparative studies or randomized controlled trials (RCTs) if BM-MNCs were used to treat patients with IS in any phase after the index stroke. One randomized trial, two non-randomized comparative trials and four single-arm open-label trials (total seven studies) involving 227 subjects (137 patients and 90 controls) were included in the systematic review and meta-analysis. The pooled proportion for favourable clinical outcome (modified Rankin Scale score ≤2) in six studies involving 122 subjects was 29% (95% CI 0.16-0.43) who were exposed to BM-MNCs and pooled proportion for favourable clinical outcome of 69 subjects (taken from two trials) who did not receive BM-MNCs was 20% (95% CI 0.12-0.32). The pooled difference in the safety outcomes was not significant between both the groups. Our systematic review suggests that BM-MNC therapy is safe up to 1 year post-intervention and is feasible; however, its efficacy in the case of IS patients is debatable. Well-designed randomized controlled trials are required to provide more information on the efficacy of BM-MNC transplantation in patients with IS.
authors: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors: A
authors: A
authors: Kumar
authors: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors: M
authors: M
authors: Prasad
authors: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors: V P
authors: VP
authors: Jali
authors: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors: A K
authors: AK
authors: Pandit
authors: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors: S
authors: S
authors: Misra
authors: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors: P
authors: P
authors: Kumar
authors: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors: K
authors: K
authors: Chakravarty
authors: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors: P
authors: P
authors: Kathuria
authors: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors: A
authors: A
authors: Gulati
mesh_terms: D001853:Bone Marrow / Q000502:physiology; D016026:Bone Marrow Transplantation / Q000379:methods*; D002545:Brain Ischemia / Q000175:diagnosis / Q000628:therapy*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods; D002986:Clinical Trials as Topic / Q000379:methods; D006801:Humans; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome
keywords: ischaemic stroke; mononuclear cell; stem cell therapy; stems cells; subacute ischaemic stroke