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Stem-cell therapy could have benefits and risks for heart-attack patients (pp 746, 751, 783)
March 03, 2004Two studies in this week's issue of THE LANCET raise questions about the feasibility and safety of stem-cell therapy for heart disease, suggesting that such treatments could have both benefits and drawbacks.
Adult haemopoietic stem cells give rise to blood cells, and are thought to be able to generate other types of cell. Recent studies have investigated the potential of stem cells to reverse heart damage caused by diseases such as acute myocardial infarction (heart attack). Use of granulocyte-colony stimulating factor (G-CSF) to mobilise stem cells has shown promise, but its safety has not been tested in patients with myocardial infarction.
Hyun-Jae Kang, Huo-Soo Kim, and colleagues from Seoul National University, Republic of Korea, studied 27 patients with stable myocardial infarction who underwent coronary stenting. After follow-up assessment in 11 patients, the investigators noted improved heart function in the seven who were randomly assigned to receive an infusion of their own peripheral blood stem-cells and G-CSF. However, an unexpectedly high rate of in-stent restenosis (recurrence of coronary artery narrowing) was seen in patients given G-CSF, either alone or in combination with stem-cell infusion, and therefore trial enrolment was stopped.
In a Research letter (p 783), Richard Vulliet from the University of California and colleagues report that after being injected with bone-marrow stem-cells, evidence of myocardial infarction was seen in the hearts of dogs.
In a Commentary (p 746), Hiroaki Matsuba (Kyoto University Hospital, Japan) notes that these potential complications should be investigated thoroughly before such methods are more widely used in patients.
Lancet
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