Cancer Risk Is Not Increased in Patients Treated for Orthopaedic Diseases with Autologous Bone Marrow Cell Concentrate

Mar 3

Cancer Risk Is Not Increased in Patients Treated for Orthopaedic Diseases with Autologous Bone Marrow Cell Concentrate

Philippe Hernigou, MD; Yasuhiro Homma, MD; Charles-Henri Flouzat-Lachaniette, MD; Alexandre Poignard, MD; Nathalie Chevallier, PhD; Helene Rouard, MD

J Bone Joint Surg Am, 2013 Dec 18; 95 (24): 2215 -2221 .

The Orthobiologic Institute (TOBI) Alumni Philippe Hernigou publishes a study in the Journal of Bone and Joint Surgery titled:  Cancer risk is not increased in patients treated for orthopaedic diseases with autologous bone marrow cell concentrate.

This retrospective review article evaluated the incidence of tumor formation at the site of treatment and elsewhere in patients who received bone marrow-derived mesenchymal stem cells (MSCs) for the treatment of non-neoplastic orthopedic lesions.  Previous studies which examined cytotherapy predominantly focused on the beneficial outcomes of treatment with short follow-up periods. However, it is important to keep in mind the safety profile of such treatments.  It is thought that MSCs may induce tumorigenesis by differentiating into various tissues and by supporting tumor angiogenesis.

This study included 1873 patients who received bone marrow concentrate progenitor cells in treatment of osseous lesions. It was hypothesized that, based on the MSC replication rate of every 2-4 days in culture, a small tumor would be observed within a few months time if it were present.  The follow-up period of clinical re-evaluation in the study, with radiographs and/or MRIs, ranged from 5 to 22 years.  No cases of MRI evidence of tumorigenesis at the site of implantation were observed.

Secondly, the risk of cancer diagnosed in areas other than the site of implantation was studied.  The same population was used to analyze the occurrence of cancers by age, gender, sites of cancer, pathology, and period of follow-up from time of first operation (ranged 5-20 years with a mean of 12.5 years).  Overall, an expected number of cancers was determined to be between 97-108 for the population based on the French population standardized incidence ratio.  In the study, only 53 cancers were diagnosed in 52 patients in areas other than the treatment site.

In conclusion, patients in this cohort that were treated with autologous MSCs did not have a higher incidence of cancer at the treatment site or elsewhere compared to the general population.

For more of the latest research on regenerative medicine with Dr. Philippe Hernigou, be sure to attend the 6th Annual TOBI: The Orthobiologic Institute PRP & Regenerative Medicine Symposium on June 12-14, 2015 in Las Vegas, Save $300 OFF Registration with Promo Code: TOBIBLOG

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