71.1.3.3 Cell-Based Therapy
Autologous or allogeneic hematopoietic stem cell transplantation is now a routine
procedure and has been successfully used for treatment of variety of hematological
conditions such as lymphoma, multiple myeloma, leukemia, anemias, solid tumors
like neuroblastoma and germ cell tumors. Also selected autoimmune conditions like
systemic lupus erythematosus have also been treated using stem cells. According to
estimates more than 50,000 autologous and allogeneic transplantation procedures
are performed every year worldwide [ 8 ].
The current interest in stem cell transplant has evolved and the research focus shifted
to use the general capacity of stem cells to repair or restore damaged tissue and recover
lost function. The prospect of using undifferentiated stem cells to maintain, recover and
improve organ function has opened a new era of research especially in diseases when
there is no cure, alterative treatment or where organ transplant is not an option.
Approximately 128 million people suffer from chronic, degenerative, and acute dis-
eases, and stem cell therapies hold great promise in the treatment of many of these
diseases. Advances in stem cell biology have allowed expanded the use of stem cells to
treat non-malignant diseases. These applications include treatment of autoimmune dis-
eases, restoring or normalizing hematopoietic function, and treating inborn errors of
metabolism. The goal of immunoablative therapy followed by HSCT is aimed at reset-
ting the patient’s immune system and allow outgrowth of a nonautogressive immune
system from reinfused hematopoietic stem cells allowing the immune system to shift
from a highly pro-inflammatory disease environment to a less inflammatory one [ 9 , 10 ].
Both autologous and allogeneic stem cells can been used to treat various immune
mediated diseases including multiple sclerosis (MS), systemic sclerosis (SSc), sys-
temic lupus erythematosus (SLE), and rheumatoid arthritis (RA) [ 11 ].
Stem cell derived cells; tissues and possibly organs may become a renewable
source of replacement cells and tissues to treat diseases including cancer, diabetes,
macular degeneration, spinal cord injury, stroke, burns, heart disease, osteoarthritis,
and rheumatoid arthritis. However, ethical concerns have also been raised in the use
of stem cells, especially use of embryonic stem cells, for purposes of research and
disease treatment. The idea of sacrificing human embryo has prevented clinical trials
using embryonic stem cells in countries like the United States. The treatment effi-
cacy of stem cells in tissue repair is also questionable fuelling such concerns. Overall,
there has been scientific disagreement about the ability of hematopoietic stem cells
to differentiate into cells that could impact tissue angiogenesis and regeneration.
Clinical trials with systemic and direct injection of stem cells to achieve repair have
shown mixed results. The PROTECT-CAD trial showed the most promising results,
in which bone marrow mononuclear cells were injected directly into ischemic myo-
cardium in patients with refractory myocardial ischemia [ 12 ].
However, on-going research in this area has now made it possible to produce a
stem cell from almost any other human cell instead of using embryos as needed
previously [ 13 ]. This has alleviated some of the ethical concerns and has created
more opportunities in use of stem cells for tissue repair and regeneration.
Recently, stem cells have been successfully used in treatment of non-
hematological conditions in humans with successful cartilage regeneration in
1 Current Indications and Overview of Molecular Imaging Techniques...