Feasibility of autologous cord blood cells for infants with hypoxic-ischemic encephalopathy

J Pediatr. 2014 May;164(5):973-979.e1. doi: 10.1016/j.jpeds.2013.11.036. Epub 2013 Dec 31.

Abstract

Objective: To assess feasibility and safety of providing autologous umbilical cord blood (UCB) cells to neonates with hypoxic-ischemic encephalopathy (HIE).

Study design: We enrolled infants in the intensive care nursery who were cooled for HIE and had available UCB in an open-label study of non-cyropreserved autologous volume- and red blood cell-reduced UCB cells (up to 4 doses adjusted for volume and red blood cell content, 1-5 × 10(7) cells/dose). We recorded UCB collection and cell infusion characteristics, and pre- and post-infusion vital signs. As exploratory analyses, we compared cell recipients' hospital outcomes (mortality, oral feeds at discharge) and 1-year survival with Bayley Scales of Infant and Toddler Development, 3rd edition scores ≥85 in 3 domains (cognitive, language, and motor development) with cooled infants who did not have available cells.

Results: Twenty-three infants were cooled and received cells. Median collection and infusion volumes were 36 and 4.3 mL. Vital signs including oxygen saturation were similar before and after infusions in the first 48 postnatal hours. Cell recipients and concurrent cooled infants had similar hospital outcomes. Thirteen of 18 (74%) cell recipients and 19 of 46 (41%) concurrent cooled infants with known 1-year outcomes survived with scores >85.

Conclusions: Collection, preparation, and infusion of fresh autologous UCB cells for use in infants with HIE is feasible. A randomized double-blind study is needed.

Trial registration: ClinicalTrials.gov NCT00593242.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child, Preschool
  • Combined Modality Therapy
  • Cord Blood Stem Cell Transplantation / methods*
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / etiology
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Hypothermia, Induced
  • Hypoxia-Ischemia, Brain / complications
  • Hypoxia-Ischemia, Brain / mortality
  • Hypoxia-Ischemia, Brain / surgery*
  • Hypoxia-Ischemia, Brain / therapy
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / mortality
  • Infant, Premature, Diseases / surgery
  • Infant, Premature, Diseases / therapy
  • Male
  • Pilot Projects
  • Severity of Illness Index
  • Transplantation, Autologous / methods
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT00593242