Safety Study of Umbilical Cord Blood To Treat Pediatric Traumatic Brain Injury

Charles Cox

Status and phase

Withdrawn

Phase 2

Phase 1

Conditions

Traumatic Brain Injury

Treatments

Biological: Autologous cord blood

Study type

Interventional

Funder types

Other

Identifiers

NCT01251003

HSC-MS-10-0061

Details and patient eligibility

About

The purpose of this study is to determine if it is safe to use stored autologous Human Umbilical Cord Blood (hUCB) to treat pediatric patients that sustain a severe or moderate Traumatic Brain Injury (TBI), and have not fully recovered as measured by the Glasgow Outcome Score-Expanded (GOS-EC)/Child at 6 to 18 months post-injury.

Full description

Traumatic brain injury is the primary cause of pediatric trauma related morbidity and mortality. Currently there is no reparative therapeutic option available, and all interventions are designed to prevent injury progression or secondary brain injury. Pre-clinical data suggest that progenitor cellular infusions may reduce the severity of injury by a number of proposed mechanisms. The current study proposes a Phase 1 Safety Trial using stored autologous UCB to treat patients that sustain a severe or moderate TBI, and have not fully recovered as measured by the Glasgow Outcome Score-Expanded/Child at 6 to 18 months post-injury. We have chosen to use one bank that uses standardized processing and storage protocol to reduce cell product variability.

Families who have banked hUCB at Cord Blood Registry, Inc. (CBR), will be prospectively notified of the possibility of using their child's stored UCB if they sustain a moderate or severe TBI and have a persistent deficit at 6-18 months. Prior to enrolling in the study, patients will have their medical records, imaging studies reviewed, and a telephone interview will determine potential eligibility and exclusion criteria. If eligible, the patients will travel to Houston to undergo a medical history and physical exam, neuropsychiatric evaluation, DT-MRI imaging of the brain, and baseline laboratory evaluation. The UCB will be shipped to the Center for Cell and Gene Therapy for reanimation and characterization/determination of release criteria of the cell product (contamination-free). The UCB will be infused intravenously and the patient will be monitored as an in-patient in the Pediatric Intensive Care Unit (PICU) located within Children's Memorial Hermann Hospital for 24 hours, after which the patient will be discharged but will return the next day for a final examination. Follow-up visits will occur back at UT-Houston at 180 days, 1 year and 2 years post-infusion - these visits will include medical history and physical exam, neurological and neuropsych evaluations, and DT-MRI imaging of the brain.

Sex

All

Ages

18 months to 17 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Hospital admission Glasgow Coma Score between 3 and 12 at the time of injury
Injury occurring 6 to 18 months prior to study cord blood infusion (+/- 30 days)
Ability of child and caregiver to travel to Houston, and stay for at least 4 days, and to return for all Follow-up visits
Ability of child to understand (and speak) English
Child's own cord blood banked at Cord Blood Registry

Exclusion criteria

Inability to obtain all pertinent medical records, including pertinent physician notes, laboratory findings, and radiographic images, related to the original injury, hospitalization and rehabilitation
Recent radiographic evidence of extensive stroke as evidenced by >100ml lesion
Pre-injury history of seizure disorder and/or neurological impairment
Obliteration of perimesencephalic cistern on initial head CT/MRI
Initial hospital Intracranial Pressure (ICP) > 40
Unhealed fractures or wounds including osteomyelitis
Pneumonia, or chronic lung disease requiring oxygen
Spinal cord injury as diagnosed by CT or MR imaging or by clinical findings
Cord blood sample contamination
Participation in a concurrent intervention study