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Autologous bone marrow-derived mononuclear cell (BM-MNC) therapy is an investigational biologic treatment developed by the Johann Wolfgang Goethe University Hospital for the treatment of chronic post-infarction heart failure. The therapy involves the extraction of a patient's own bone marrow through iliac crest aspiration, followed by the isolation of the mononuclear cell fraction—which contains hematopoietic stem cells and mesenchymal stem cells—via Ficoll density-gradient centrifugation. These cells are then administered to the patient through intracoronary infusion into the vessel or bypass supplying the previous infarct area. The treatment is hypothesized to improve cardiac function and survival through paracrine signaling and the stimulation of endogenous repair mechanisms in the damaged myocardium. The REPEAT trial (NCT01693042) specifically investigated the impact of single versus repeated applications of this therapy on mortality in heart failure patients.
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