Stem Cell Therapy dangers and risks

I received a disturbing call from a woman in Texas recently.  She was having some complications from the “stem cell” treatment that she received in her hometown.

In what is becoming a more common email or call from people not our patients, she revealed that she believed that her doctor was inexperienced in the Stem Cell procedure and did not know how to address her complications.

Even though I did not have the luxury of examining her, I tried to ask some questions to help her with her situation.

Stem Cell Therapy dangers and risks – the wrong stem cells

It seems, that she had received placental cells. They were injected into her knee and it caused a severe inflammatory response that left her with a great deal of pain.  I did wish her the best and try to offer some advice, but also let her know that it is not legal nor recommended to inject placental cells into a patient.

While we have found the use of stem cells for the symptomatic treatment of arthritis and pain to be very helpful in our practice, one must be very cautious as to know what they are receiving.

As I mentioned, placental cells are not only illegal, but are immature cells that can have mutagenic properties.  That is, they have the ability to turn into cancer cells and furthermore it is uncertain if the body can reject them since they are not harvested from the person who is receiving the treatment.  These cells, also differentiate to form both blood cells and tissue cells so there is a great deal of insufficiency if you are looking to heal damaged tissue.

Bone marrow derived stem cells also have this same property of containing cell lines that turn into blood cells.  There are certain areas, like the tibia, where the bone marrow contains many more blood cells then areas such as the hip, which contain more mesenchymal cells.  Certain doctors have recommended tibial bone marrow draws for the use of bone marrow prolotherapy from the tibia, but this has very little scientific backing to be included as a stem cell source.  There is also no research whatsoever showing its efficacy.

Many other doctors use bone marrow from the hip in their stem cell procedure. While this is a richer source of mesenchymal cells when compared to the tibia it is still a very poor source of stem cells.

Results from stem cell procedures not only depend on the cell type and where they are injected, but also the diagnostic skill and approach of the physician.  While stem cells may have amazing properties, they are not so magical where we can just inject stem cells into a joint and hope for good results.  As a physician, it is our job to evaluate and treat any problem surrounding, above and below the joint – using a very careful physical examination.  A comprehensive approach, not a single sided approach, will yield the best results for the patient.

Growth hormone has also been touted by one physician as useful in a stem cell mixture.  That physician is conducting a study on this, but it still remains unproven.  We had used this in power injection solution well over 10 years ago and stopped because it did not produce any significant clinical benefit.  Furthermore, stem cells do need to be combined with a variety of growth factors in order to further their differentiation into new tissue.  This can be achieved by using specialized forms of PRP along with the stem cell mixture.  Both ourselves with our partners at Kensey and Dr. Centeno from Regenexx has done laboratory tests to look at the importance of this.  There is a large variation in how stem cells perform based upon the environment that they are given with the PRP.

In summary, while these procedures have tremendous potential, we need to follow in the best of our knowledge base and follow our outcomes.  Eventually, our technology will expand, and in the future we will have the capability to harvest stem cells in less than a half hour… But this will take several years of development.

Scott Greenberg MD