It can be difficult to tease out the evidence-based science amidst the claims of successful adult stem cell-based treatments for a range of health problems from joint pain to Parkinson’s disease, macular degeneration, and spinal cord injury. Even a number of well-respected medical centers now offer patients regenerative medicine treatments that use the patient’s own fat or bone marrow cells or extracts created from platelets in their blood. But there’s not yet strong clinical evidence for the efficacy and safety of these treatments, and none have been approved by the FDA, so before delving into the world of regenerative medicine and treatments that use adult stem cells, it’s wise to learn more about the current clinical landscape.

At this time, the only FDA-approved treatments that transplant adult stem cells from bone marrow or blood are those that treat blood cancers and disorders of the blood and immune system. There are also some treatments that use these stem cells in clinical trials. Although treatments like bone marrow aspiration and concentration injections for joint pain are being offered by some physicians in the U.S., there are no double-blind clinical trials, the gold standard for medical research, that show that these treatments are effective and safe. In fact, a recent study that compared the pain relief offered by bone marrow injections and saltwater injections for knee pain both delivered the same level of pain relief and the bone marrow injections did not promote a regenerative benefit in the knee cartilage. In addition, some adult stem cell treatments have harmed patients, such as patients in Florida who underwent stem cell injections in the eye to treat macular degeneration and experienced pain and loss of sight, and another patient who had stem cell injections for arthritis and experienced an adverse reaction that left her comatose for a month.

Should you bank your stem cells?

While the science may not yet be viable for adult stem cell-based treatments, there are promising treatments both in development and in clinical trials. At the University of Miami’s Interdisciplinary Stem Cell Institute, for example, Dr. Joshua Hare, the Institute’s director, is conducting an early-stage clinical trial focused on using allogenic stem cells (adult stem cells from a donor) to treat the symptoms of frailty in the elderly. The study found that elderly patients who received a transplant of stem cells from healthy younger people were able to breathe more easily and walk farther after a single infusion. Other researchers are exploring the potential of adult stem cells to treat multiple sclerosis, heart failure, and autoimmune diseases, including lupus and rheumatoid arthritis.

This raises the question: Does it make sense to bank your stem cells while you’re younger and healthier so that you can benefit from treatments that may be developed in the coming years? There are several companies that currently offer adult stem cell banking and storage. Some collect stem cells from fat, some perform a blood draw then extract and culture the cells, and some collect these cells from bone marrow. The cells are then cryogenically frozen and banked until you need them.

There are potential health risks to stem cell harvesting, including the risk of infection and the risks that come with sedation if you opt for the fat or bone marrow approach. Researchers do not have evidence that shows that cells banked now will not degrade over time. In addition, if you develop a disease later in life, such MS or leukemia, it is possible that the banked cells were in the early stages of developing that disease and won’t be useful to treat it. Other issues to consider are the cost of banking cells, which can be significant, and the fact that donor stem cells will not cause an immune reaction in the recipient, so you should consider the option of getting the cells you need from a young, healthy person when the need arises rather than relying on your own banked cells.

If you’re considering undergoing stem cell therapy or banking your stem cells, the first step should be to consult with your advisor, who can provide evidence-based information and advice. Before choosing to undergo any stem cell-based treatment, ask your physician these questions:

• What is the scientific evidence that this treatment could work for my disease or condition, and where has this evidence been published?
• Is this treatment part of a formal clinical trial?
• What other treatment options should I consider and what’s the clinical evidence that supports these treatments?
• What are the potential benefits, risks, and side effects of the treatment?
• How many people have you treated with this therapy, and what were the results of treatment?
• What is the source of the stem cells used in the treatment, how are they identified, isolated, and grown, and how is the treatment performed?

Miles J. Varn is chief medical officer, PinnacleCare, and can be reached on LinkedIn.

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