Original Title: Terapia con células madre: aplicaciones clínicas

Authors' recommendations: Stem cells are non-specialized cells that have the capacity for self-renewal and differentiation to specific cell lines. Stem cells have been used for hematopoietic stem cell transplant in hematologic and immunodeficiency diseases for decades. In the last few years, stem cell therapy has been proposed for the treatment of several orthopedic, neurodegenerative, and heart conditions; also its potential benefits have promoted an increasing interest in collecting and storing umbilical cord and placental blood for later use. This document summarizes the evidence found in relevant literature reviews about the clinical usefulness of stem cells for indications other than hematopoietic stem cell transplant harvested from bone marrow. Low-quality evidence suggests that in patients with chronic ischemic heart disease or congestive heart failure, stem cell therapy would decrease mortality, although it would not modify the composite outcome rate of mortality, infarction or readmissions in these patients. There is little evidence on the usefulness of this therapy in stroke patients. Low-quality evidence suggests that stem cell therapy in patients with insulin-requiring diabetes mellitus would slightly reduce the serum glycated hemoglobin levels (HbA1c), although it would not improve fasting glucose or c-peptide levels. No evidence of other relevant clinical outcomes has been found. Very low-quality evidence found about the use of stem cells for corneal reconstruction does not allow to draw conclusions on the usefulness of this treatment, or on its usefulness for other conditions such as fractures or tendinopathies. No clinical evidence was found about the usefulness of stem cell therapy in skin reconstruction, neurodegenerative disorders or about the potential benefit of umbilical cord stem cell storage. In our country, the activities related to the use of human cells for further implant are under the scope of the Unique Central National Institute Coordinator of Ablation and Implant (INCUCAI, Instituto Nacional Central Único Coordinador de Ablación e Implante), which determines that the only safe stem cell therapies are those used for blood disorders that can be cured with bone marrow transplant. The remaining therapeutic indications are considered experimental and its use in human beings should be carried out as part of an INCUCAI-approved research protocol. No coverage policies explicitly covering stem cell therapies for indications other than bone marrow transplant have been found in other countries of the region. Additionally, United States private insurance companies and public sponsors, such as the Australian health authority, consider the use of stem cells for the treatment hematological diseases only. Other indications are considered experimental.

Project Status: Completed

Year Published: 2021

URL for published report: https://www.iecs.org.ar/publicacion/?id=21093

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)