Skip to main content
Top
Published in: International Orthopaedics 8/2016

Open Access 01-08-2016 | Original Paper

A multi-center analysis of adverse events among two thousand, three hundred and seventy two adult patients undergoing adult autologous stem cell therapy for orthopaedic conditions

Authors: Christopher J. Centeno, Hasan Al-Sayegh, Michael D. Freeman, Jay Smith, William D. Murrell, Rostyslav Bubnov

Published in: International Orthopaedics | Issue 8/2016

Login to get access

Abstract

Introduction

The purpose of the present investigation is to report on detailed complications among a much larger group of 2372 orthopaedic patients treated with stem cell injections who were followed in a treatment registry for up to nine years.

Methods

All patients underwent an MSC-based, percutaneous injection treatment of an orthopaedic condition between December 2005 and September 2014 at one of 18 clinical facilities. Treated areas of the body included the knee, hip, ankle/foot, hand/wrist, elbow, shoulder, and spine. The patients were followed prospectively via enrollment in a treatment registry. Patients were followed prospectively at one, three, six and 12 months, and annually thereafter, using an electronic system, ClinCapture software.

Results

A total of 3012 procedures were performed on 2372 patients with follow-up period of 2.2 years. A total of 325 adverse events were reported. The majority were pain post-procedure (n = 93, 3.9 % of the study population) and pain due to progressive degenerative joint disease (n = 90, 3.8 % of the study population). Seven cases reported neoplasms, a lower rate than in the general population. The lowest rate of adverse events was observed among patients injected with BMC alone.

Conclusion

Lowest rate of adverse events was among those patients receiving BMC injections alone, but the higher rate of AEs for BMC plus adipose and cultured cells was readily explained by the nature of the therapy or the longer follow-up. There was no clinical evidence to suggest that treatment with MSCs of any type in this study increased the risk of neoplasm.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hernigou P, Beaujean F (1997) Pseudarthrosis treated by percutaneous autologous bone marrow graft. Rev Chir Orthop Reparatrice Appar Mot 83(6):495PubMed Hernigou P, Beaujean F (1997) Pseudarthrosis treated by percutaneous autologous bone marrow graft. Rev Chir Orthop Reparatrice Appar Mot 83(6):495PubMed
2.
go back to reference Centeno CJSJ, Cheever M, Freeman M, Robinson B et al (2011) A case series of percutaneous treatment of non-union fractures with autologous, culture expanded, bone marrow derived, mesenchymal stem cells and platelet lysate. J Bioengineer & Biomedical Sci S2:007. doi:10.4172/2155-9538.S2-007 Centeno CJSJ, Cheever M, Freeman M, Robinson B et al (2011) A case series of percutaneous treatment of non-union fractures with autologous, culture expanded, bone marrow derived, mesenchymal stem cells and platelet lysate. J Bioengineer & Biomedical Sci S2:007. doi:10.​4172/​2155-9538.​S2-007
4.
go back to reference Cvetkovic VJ, Najdanovic JG, Vukelic-Nikolic MD, Stojanovic S, Najman SJ (2015) Osteogenic potential of in vitro osteo-induced adipose-derived mesenchymal stem cells combined with platelet-rich plasma in an ectopic model. Int Orthop 39(11):2173–2180. doi:10.1007/s00264-015-2929-x CrossRefPubMed Cvetkovic VJ, Najdanovic JG, Vukelic-Nikolic MD, Stojanovic S, Najman SJ (2015) Osteogenic potential of in vitro osteo-induced adipose-derived mesenchymal stem cells combined with platelet-rich plasma in an ectopic model. Int Orthop 39(11):2173–2180. doi:10.​1007/​s00264-015-2929-x CrossRefPubMed
5.
go back to reference Flouzat-Lachaniette CH, Heyberger C, Bouthors C, Roubineau F, Chevallier N, Rouard H, Hernigou P (2015) Osteogenic progenitors in bone marrow aspirates have clinical potential for tibial non-unions healing in diabetic patients. Int Orthop. doi:10.1007/s00264-015-3046-6 Flouzat-Lachaniette CH, Heyberger C, Bouthors C, Roubineau F, Chevallier N, Rouard H, Hernigou P (2015) Osteogenic progenitors in bone marrow aspirates have clinical potential for tibial non-unions healing in diabetic patients. Int Orthop. doi:10.​1007/​s00264-015-3046-6
6.
go back to reference Lee GR, Wintrobe MM (1993) Wintrobe's clinical hematology, vol 9. Lea & Febiger, Philadelphia Lee GR, Wintrobe MM (1993) Wintrobe's clinical hematology, vol 9. Lea & Febiger, Philadelphia
7.
go back to reference Centeno CJ, Freeman MD (2014) Percutaneous injection of autologous, culture-expanded mesenchymal stem cells into carpometacarpal hand joints: a case series with an untreated comparison group. Wien Med Wochenschr 164(5):83–87. doi:10.1007/s10354-013-0222-4 CrossRefPubMed Centeno CJ, Freeman MD (2014) Percutaneous injection of autologous, culture-expanded mesenchymal stem cells into carpometacarpal hand joints: a case series with an untreated comparison group. Wien Med Wochenschr 164(5):83–87. doi:10.​1007/​s10354-013-0222-4 CrossRefPubMed
8.
go back to reference Centeno CJ, Pitts J, Al-Sayegh H, Freeman MD (2015) Anterior cruciate ligament tears treated with percutaneous injection of autologous bone marrow nucleated cells: a case series. J Pain Res 8:437–447. doi:10.2147/JPR.S86244 Centeno CJ, Pitts J, Al-Sayegh H, Freeman MD (2015) Anterior cruciate ligament tears treated with percutaneous injection of autologous bone marrow nucleated cells: a case series. J Pain Res 8:437–447. doi:10.​2147/​JPR.​S86244
9.
go back to reference Centeno CJ, Schultz JR, Cheever M, Freeman M, Faulkner S, Robinson B, Hanson R (2011) Safety and complications reporting update on the re-implantation of culture-expanded mesenchymal stem cells using autologous platelet lysate technique. Curr Stem Cell Res Ther 6(4):368–378CrossRefPubMed Centeno CJ, Schultz JR, Cheever M, Freeman M, Faulkner S, Robinson B, Hanson R (2011) Safety and complications reporting update on the re-implantation of culture-expanded mesenchymal stem cells using autologous platelet lysate technique. Curr Stem Cell Res Ther 6(4):368–378CrossRefPubMed
11.
go back to reference Hernigou P, Poignard A, Beaujean F, Rouard H (2005) Percutaneous autologous bone-marrow grafting for nonunions. Influence of the number and concentration of progenitor cells. J Bone Joint Surg (Am Vol) 87(7):1430. doi:10.2106/JBJS.D.02215 Hernigou P, Poignard A, Beaujean F, Rouard H (2005) Percutaneous autologous bone-marrow grafting for nonunions. Influence of the number and concentration of progenitor cells. J Bone Joint Surg (Am Vol) 87(7):1430. doi:10.​2106/​JBJS.​D.​02215
13.
go back to reference Centeno C, Pitts J, Al-Sayegh H, Freeman M (2014) Efficacy of autologous bone marrow concentrate for knee osteoarthritis with and without adipose graft. BioMed Res Int 2014:370621–370629. doi:10.1155/2014/370621 Centeno C, Pitts J, Al-Sayegh H, Freeman M (2014) Efficacy of autologous bone marrow concentrate for knee osteoarthritis with and without adipose graft. BioMed Res Int 2014:370621–370629. doi:10.​1155/​2014/​370621
14.
go back to reference Centeno CJ, Schultz JR, Cheever M, Robinson B, Freeman M, Marasco W (2010) Safety and complications reporting on the re-implantation of culture-expanded mesenchymal stem cells using autologous platelet lysate technique. Curr Stem Cell Res Ther 5(1):81CrossRefPubMed Centeno CJ, Schultz JR, Cheever M, Robinson B, Freeman M, Marasco W (2010) Safety and complications reporting on the re-implantation of culture-expanded mesenchymal stem cells using autologous platelet lysate technique. Curr Stem Cell Res Ther 5(1):81CrossRefPubMed
15.
go back to reference Hernigou P, Homma Y, Flouzat-Lachaniette C-H, Poignard A, Chevallier N, Rouard H (2013) Cancer risk is not increased in patients treated for orthopaedic diseases with autologous bone marrow cell concentrate. J Bone Joint Surg (Am Vol) 95(24):2215. doi:10.2106/JBJS.M.00261 CrossRef Hernigou P, Homma Y, Flouzat-Lachaniette C-H, Poignard A, Chevallier N, Rouard H (2013) Cancer risk is not increased in patients treated for orthopaedic diseases with autologous bone marrow cell concentrate. J Bone Joint Surg (Am Vol) 95(24):2215. doi:10.​2106/​JBJS.​M.​00261 CrossRef
18.
go back to reference Rabago D, Kijowski R, Woods M, Patterson JJ, Mundt M, Zgierska A, Grettie J, Lyftogt J, Fortney L (2013) Association between disease-specific quality of life and magnetic resonance imaging outcomes in a clinical trial of prolotherapy for knee osteoarthritis. Arch Phys Med Rehabil 94(11):2075. doi:10.1016/j.apmr.2013.06.025 CrossRefPubMed Rabago D, Kijowski R, Woods M, Patterson JJ, Mundt M, Zgierska A, Grettie J, Lyftogt J, Fortney L (2013) Association between disease-specific quality of life and magnetic resonance imaging outcomes in a clinical trial of prolotherapy for knee osteoarthritis. Arch Phys Med Rehabil 94(11):2075. doi:10.​1016/​j.​apmr.​2013.​06.​025 CrossRefPubMed
20.
go back to reference Mashaw R (2007) OHRP issues new guidance on unanticipated problems, adverse events. Adverse Event Reporting News 4(2):1 Mashaw R (2007) OHRP issues new guidance on unanticipated problems, adverse events. Adverse Event Reporting News 4(2):1
21.
go back to reference SAS Institute (2014) SII (issued 2014) SAS software version 9.4. SAS Institute, Cary, NC SAS Institute (2014) SII (issued 2014) SAS software version 9.4. SAS Institute, Cary, NC
23.
go back to reference Vangsness JCT, Farr NJ, Boyd J, Dellaero DT, Mills CR, LeRoux-Williams M (2014) Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg (Am Vol) 96(2):90. doi:10.2106/JBJS.M.00058 CrossRef Vangsness JCT, Farr NJ, Boyd J, Dellaero DT, Mills CR, LeRoux-Williams M (2014) Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg (Am Vol) 96(2):90. doi:10.​2106/​JBJS.​M.​00058 CrossRef
25.
26.
go back to reference Tynan GA, Hearnden CH, Oleszycka E, Lyons CL, Coutts G, O'Connell J, Corrigan MA, Lynch L, Campbell M, Callanan JJ, Mok KH, Geoghegan J, O'Farrelly C, Allan SM, Roche HM, O'Shea DB, Lavelle EC (2014) Endogenous oils derived from human adipocytes are potent adjuvants that promote IL-1α-dependent inflammation. Diabetes 63(6):2037CrossRefPubMed Tynan GA, Hearnden CH, Oleszycka E, Lyons CL, Coutts G, O'Connell J, Corrigan MA, Lynch L, Campbell M, Callanan JJ, Mok KH, Geoghegan J, O'Farrelly C, Allan SM, Roche HM, O'Shea DB, Lavelle EC (2014) Endogenous oils derived from human adipocytes are potent adjuvants that promote IL-1α-dependent inflammation. Diabetes 63(6):2037CrossRefPubMed
29.
Metadata
Title
A multi-center analysis of adverse events among two thousand, three hundred and seventy two adult patients undergoing adult autologous stem cell therapy for orthopaedic conditions
Authors
Christopher J. Centeno
Hasan Al-Sayegh
Michael D. Freeman
Jay Smith
William D. Murrell
Rostyslav Bubnov
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 8/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3162-y

Other articles of this Issue 8/2016

International Orthopaedics 8/2016 Go to the issue