Published online Oct 26, 2019. doi: 10.4252/wjsc.v11.i10.891
Peer-review started: March 15, 2019
First decision: June 3, 2019
Revised: June 12, 2019
Accepted: August 20, 2019
Article in press: August 20, 2019
Published online: October 26, 2019
Cerebral palsy (CP) is a severe, uncurable motor disability resulting from perinatal complications. It is a challenge for our health system and a burden for both patients and their families.
During the last years, stem cell therapy emerged as a novel treatment option. Clinical trials report promising results and create high expectations. However, most trials are of poor quality and neither randomized nor controlled, so the scientific evidence remains doubtful.
The aim of our meta-analysis was to investigate the effect of stem cell treatment on the gross motor function in children with CP.
With a systematic literature search on PubMed and EMBASE, we identified the eligible randomized controlled clinical trials (RCTs). We performed a random-effects meta-analysis focusing on the change in gross motor function and calculated the pooled standardized mean differences of the 6- and/or 12-mo-outcome.
We identified a total of 8 RCTs 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.
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.
Considering that this small number may not be enough to represent the whole CP population, our meta-analysis detected a small but significant improvement in the gross motor function favoring the stem cell group. However, the magnitude of the effect is limited. In the future, high-quality research with a more homogenous study population is needed to bring more clarity.