Stem Cell Questions

In my clinic I often see patients who have researched various claims made on the internet. These claims include the use of BONE MARROW ASPIRATE (BMA) which is often referred to as STEM CELL THERAPY. Here are the facts.

True stem cells (a.k.a mesenchmyal stem cells or MSCs) are a small population within the bone marrow of a healthy person; perhaps 1 in 10000 cells. So, without purification using pretty fancy equipment (for example a cell sorter based upon biomarkers on the cell surface) a BMA has very few stems cells in it. I wish it were otherwise. There is at least one clinical trial taking place (see the Aldagen Company) where BMA is sent to the facility and a purification is performed; this is costly and NOT available except on a research basis at the present time.As an alternative, it is possible to take BMA from the patient, mix it with blood, and use the PRP type systems to purify a component with “monomuclear cells” that may contain at least some of the MSC population mixed in with the platelets.  This concentrate could then be placed in a cell counter to see (a) what the platelet concentrate is and (b) are there any mononuclear cells in it. Is this a shortcut with scientific validity? We don’t really know. We do know that if you advertise it as a stem cell therapy, the FDA will not be pleased. It is definitely a way to avoid regulatory scrutiny, and it may even “work”; but without careful experiments we really will never know. How about some good imaging studies before and after? Where is the data?  Depending upon the testimonials of “cured patients” is not the way to move the field forward; it didn’t work in the 19th century and it won’t work now!

So caveat emptor; do your research, and always be skeptical.