Stem cell treatment and cerebral palsy: Systemic review and meta-analysis

摘要

BACKGROUND Perinatal complications may result in life-long morbidities,among which cerebral palsy(CP)is the most severe motor disability.Once developed,CP is a nonprogressive disease with a prevalence of 1-2 per 1000 live births in developed countries.It demands an extensive and multidisciplinary care.Therefore,it is a challenge for our health system and a burden for patients and their families.Recently,stem cell therapy emerged as a promising treatment option and raised hope in patients and their families.AIM The aim is to evaluate the efficacy and safety of stem cell treatment in children with CP using a systematic review and meta-analysis METHODS We performed a systematic literature search on PubMed and EMBASE to find randomized controlled clinical trials(RCT)investigating the effect of stem cell transplantation in children with CP.After the review,we performed a randomeffects meta-analysis focusing on the change in gross motor function,which was quantified using the gross motor function measure.We calculated the pooled standardized mean differences of the 6-and/or 12-mo-outcome by the method of Cohen.We quantified the heterogeneity using the I-squared measure.RESULTS We identified a total of 8 RCT for a qualitative review.From the initially selected trials,5 met the criteria and were included in the meta-analysis.Patients’population ranged from 0.5 up to 35 years(n=282).We detected a significant improvement in the gross motor function with a pooled standard mean difference of 0.95(95%confidence interval:0.13-1.76)favoring the stem cell group and a high heterogeneity(I2=90.1%).Serious adverse events were rare and equally distributed among both intervention and control groups.CONCLUSION Stem cell therapy for CP compared with symptomatic standard care only,shows a significant positive effect on the gross motor function,although the magnitude of the improvement is limited.Short-term safety is present and further highquality RCTs are needed.