TeleHealth Medical Group is offering stem cell therapy to stroke survivors for $32,500. So it is time to ask myself if I would do it. A recent clinical study (1) raises four common sense concerns.
1. Six of the 18 subjects experienced "serious treatment emergent adverse events." While all events were resolved, it is disturbing that one-third of the people had problems after the surgery. Adverse treatment effects are real to me because I took hormone replacement therapy when it
was an exciting new way to handle menopause. Unfortunately, hormone replacement therapy raises triclyceride levels which are fats in the blood that clog blood vessels. My triclyceride levels went sky high which probably contributed to my stroke. I have made my contribution to science so I will let others take the risk associated with stem cell therapy.
2. The thrill of lifting an arm or leg one day after surgery is evident on the face of two subjects, but do isolated movements translate into functional gains? The woman who beamed while lifting her arm over her head was pregnant at the time of the video above, but can she safely carry her child in her affected arm? I have lost track of how many objects I have dropped while holding them next to my body as I walk, like dirty clothes, a book, and a pillow. The problem with tests that evaluate movement outside of a meaningful context is that stroke survivors do not know what they can do when they have a cognitive challenge. Manipulating an object while holding a squirmy, fussy baby is not the same as holding your arm in the air. As an OT I was happy when clients made gains on motor tests. A stroke showed me that passing items on a non-functional test is not good enough.
3. After surgery there were significant gains in movement on the Fugl-Meyer Motor total score, but the majority of those gains happened in the first two months (mean increase for the group = 11.4 points). Very small gains were made over the next ten months (mean additional increase = 1.4 points). Are researchers telling subjects that stem cell therapy creates a small window where they have to do intensive rehab to retrain the brain? Is Dr. Steinberg telling his clients that surgery is only the first step in recovery?
4. $32,500 is a lot of money that I need to stay in my home. I am willing to bet that TeleHealth Medical Group does not offer a guarantee that stroke survivors will see meaningful results.
1. Steinberg G, Kondziolka D, Weschler L, et al. Clinical outcomes of transplanted modified
bone marrow-derived mesenchymal stem cells in stroke: A phase 1/2a study. Stroke. 2016;47