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Evaluate the efficacy of one infusion of stem cells from autologous umbilical cord blood in patients with autism over six months after infusion as measured by changes in expressive and receptive language.
Also demonstrate improved behavior, learning, and changes in Serum tumor necrosis factor alpha (TNF-α), tumor necrosis factor beta (TNF-β), interleukin 1-alpha (IL-1α), interleukin 1-beta (IL-1β), interleukin 6 (IL-6), interleukin 10 (IL-10), and interleukin 13 (IL-13).
This is a single-center, randomized, placebo-controlled, crossover outpatient study with 15 subjects receiving one infusion of autologous umbilical cord blood (AUCB) containing a minimum of 10 million total nucleated cells per kilogram (TNC/kg) and 15 subjects receiving an infusion of placebo (saline). After the 24-week follow-up testing is conducted, the groups will crossover so that patients who initially received AUCB will receive placebo and patients who received placebo at baseline will receive the cord blood. Both groups will be tested again 24-weeks after infusion. The neuropsychologist, PI, staff from Cord Blood Registry (CBR), and parents will be blinded as to the infusion sequence.
The duration of participation for each study subject is approximately 55 weeks. This includes one screening visit over a period of approximately 6 weeks, one visit for baseline testing, one day for infusion of TNC (minimum 10 million/kg) or saline placebo followed by 24 weeks of follow-up. A second baseline visit is conducted at week-24 with the second infusion of TNC or saline placebo occurring 5-7 days after. Twenty-four additional weeks of follow-up occur after the second infusion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Autologous Cord Blood Stem Cells | Experimental |
| |
| Placebo | Placebo Comparator | Saline |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Autologous Cord Blood Stem Cells | Biological | One infusion of 60 ml syringe of study product |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Language (Total Standard Score, Range 40 - 160) | Change in language as measured by the Receptive One-Word Vocabulary Test (ROWVT-4) and Expressive One-Word Vocabulary Test (EOWVT-4) at baseline and six months following infusion of stem cells from AUCB or infusion of placebo. The ROWPVT-4 and EOWPVT-4 were administered by a neuropsychologist and are norm-referenced assessments. The ROWPVT-4 tests an individual's ability to match a spoken word with an image of an object, action, or concept. The EOWPVT-4 tests an individual's ability to name, with one word, objects, actions, and concepts when presented with color illustrations. The tests target the ability to understand the meaning of words spoken and name what is depicted on a test plate without context. Scores of 85-115 are considered to be within the average range of functioning. | Baseline and 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Behavior/Learning (Standard Score, Range 40 - 160 for Each Subtest) | Change in the Vineland Adaptive Behavior and Socialization Scales (2nd edition) between baseline and six months after infusion of AUCB containing stem cells. Vineland Adaptive Behavior and Socialization Scales consist of the following subparts: Daily Living Skills, Socialization, and Adaptive Behavior Composite (ABC). These are questionnaires completed by a parent or caregiver. Scores above 80 are classified using approximately the same ranges as IQ tests. Scores below 80 are categorized as borderline adaptive functioning (70-80); mildly deficient adaptive functioning (51-69); moderately deficient adaptive behavior (36-50); severely deficient adaptive behavior; (20-35); and markedly or profoundly deficient adaptive behavior (<20). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michael Chez, MD | Sutter Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sutter Pediatric Neurology | Sacramento | California | 95816 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23097920 | Derived | Mauron A. [Autism, stem cells, and magical powder]. Rev Med Suisse. 2012 Sep 19;8(354):1795. No abstract available. French. |
| Label | URL |
|---|---|
| Sutter Institute for Medical Research | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | Autologous Cord Blood Stem Cells First/Placebo Second | Autologous Cord Blood Stem Cells: One infusion of 60 ml syringe of study product Placebo: Saline |
| FG001 | Placebo First/Autologous Cord Blood Stem Cells Second | Autologous Cord Blood Stem Cells: One infusion of 60 ml syringe of study product Placebo: Saline |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Autologous Cord Blood Stem Cells First/Placebo Second | Autologous Cord Blood Stem Cells: One infusion of 60 ml syringe of study product Placebo: Saline |
| BG001 | Placebo First/Autologous Cord Blood Stem Cells Second |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Language (Total Standard Score, Range 40 - 160) | Change in language as measured by the Receptive One-Word Vocabulary Test (ROWVT-4) and Expressive One-Word Vocabulary Test (EOWVT-4) at baseline and six months following infusion of stem cells from AUCB or infusion of placebo. The ROWPVT-4 and EOWPVT-4 were administered by a neuropsychologist and are norm-referenced assessments. The ROWPVT-4 tests an individual's ability to match a spoken word with an image of an object, action, or concept. The EOWPVT-4 tests an individual's ability to name, with one word, objects, actions, and concepts when presented with color illustrations. The tests target the ability to understand the meaning of words spoken and name what is depicted on a test plate without context. Scores of 85-115 are considered to be within the average range of functioning. | Please note that endpoints for only the first 24 weeks were recorded due to the fact that the placebo second group may not be a true placebo group (stem cell infusion does not necessarily wash out like a drug). | Posted | Mean | Standard Deviation | units on a scale | Baseline and 6 months |
|
Adverse event data were collected over the entire study time frame (12 months).
Adverse events were measured for all participants throughout the study and not classified by arm since both arms received stem cell cord blood infusion.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | All Participants | Adverse events were measured for all participants throughout the study and not by arm since both arms received stem cell cord blood infusion. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Seasonal cold | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Michael Chez, MD | Sutter Health | (916) 773-8711 | ChezM@sutterhealth.org |
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| ID | Term |
|---|---|
| D001321 | Autistic Disorder |
| ID | Term |
|---|---|
| D000067877 | Autism Spectrum Disorder |
| D002659 | Child Development Disorders, Pervasive |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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| Placebo | Biological | Saline |
|
| Baseline and 6 months |
| Change in Knowledge and Fluid Reasoning (Scaled Score, Range 1-19 for Each Subtest) | The Stanford Binet, version 5, was used to assess the brain function. It can assess the level of intelligence across several age spans and ability levels. The Stanford-Binet looks at intelligence in five areas. In this study 2 areas were looked at: Knowledge and Fluid Reasoning that were age and condition appropriate. Each sub-test has a mean of 10 and a standard deviation of 3. The standard deviation indicates how far above or below the norm the subject's score is. Scores of 7 to 13 are considered to be within the average range of functioning. | Baseline and 6 months |
Autologous Cord Blood Stem Cells: One infusion of 60 ml syringe of study product
Placebo: Saline
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Abnormal EEG at baseline | Count of Participants | Participants |
|
| Autism Diagnostic Observation Schedule (ADOS) | The Autism Diagnostic Observation Schedule (ADOS) is a semi-structured assessment of communication, social interaction, and play (or imaginative use of materials) for individuals suspected of having autism or other pervasive developmental disorders. The total score ranges from 0 to 28 with 0 representing no abnormality present. A child is suspected to have Autism if the total ADOS score is greater than 7. The mean of the total ADOS scores is listed below. | Mean | Standard Deviation | units on a scale |
|
| Compartment infused | Each subject's cord blood unit consists of two compartments. One contains 80% total volume and the other contains 20% total volume. | Count of Participants | Participants |
|
| Weight | Mean | Standard Deviation | kilograms (kg) |
|
| TNC dose infused x 10^6/kg | The Total Nucleated Cell count or TNC is the total cell count after cord blood processing. | TNC data was not available for 2 cord blood first subjects and 5 placebo first subjects. | Mean | Standard Deviation | Number of cells infused x 10^6/kg |
|
| Viable total nucleated cell (vTNC) count infused | The viable Total Nucleated Cell count or vTNC is the count of alive cells. | TNC dose data was not available for 2 cord blood first subjects and 5 placebo first subjects. | Mean | Standard Deviation | number of alive cells x 10^6/kg |
|
| Percent viability post-thaw, (flow cytometry 7-AAD) | This measure determines the percent of stem cells that are alive. | Mean | Standard Deviation | Percent viable cells |
|
| Percent viable CD34 (cluster of differentiation) - post-thaw | CD34, a protein found on the surface of stem cells, is the best known marker for blood-forming stem cells. It is used to predict the quality of white cell count yield. | Mean | Standard Deviation | Percent viable cells |
|
| Description |
|---|
| OG000 | Autologous Cord Blood Stem Cells | Autologous Cord Blood Stem Cells: One infusion of 60 ml syringe of study product |
| OG001 | Placebo | Placebo: Saline |
|
|
| Secondary | Change in Behavior/Learning (Standard Score, Range 40 - 160 for Each Subtest) | Change in the Vineland Adaptive Behavior and Socialization Scales (2nd edition) between baseline and six months after infusion of AUCB containing stem cells. Vineland Adaptive Behavior and Socialization Scales consist of the following subparts: Daily Living Skills, Socialization, and Adaptive Behavior Composite (ABC). These are questionnaires completed by a parent or caregiver. Scores above 80 are classified using approximately the same ranges as IQ tests. Scores below 80 are categorized as borderline adaptive functioning (70-80); mildly deficient adaptive functioning (51-69); moderately deficient adaptive behavior (36-50); severely deficient adaptive behavior; (20-35); and markedly or profoundly deficient adaptive behavior (<20). | Please note that endpoints for only the first 24 weeks were recorded due to the fact that the placebo second group may not be a true placebo group (stem cell infusion does not necessarily wash out like a drug). | Posted | Mean | Standard Deviation | units on a scale | Baseline and 6 months |
|
|
|
| Secondary | Change in Knowledge and Fluid Reasoning (Scaled Score, Range 1-19 for Each Subtest) | The Stanford Binet, version 5, was used to assess the brain function. It can assess the level of intelligence across several age spans and ability levels. The Stanford-Binet looks at intelligence in five areas. In this study 2 areas were looked at: Knowledge and Fluid Reasoning that were age and condition appropriate. Each sub-test has a mean of 10 and a standard deviation of 3. The standard deviation indicates how far above or below the norm the subject's score is. Scores of 7 to 13 are considered to be within the average range of functioning. | Please note that endpoints for only the first 24 weeks were recorded due to the fact that the placebo second group may not be a true placebo group (stem cell infusion does not necessarily wash out like a drug). | Posted | Mean | Standard Deviation | units on a scale | Baseline and 6 months |
|
|
|
| 0 |
| 29 |
| 0 |
| 29 |
| 28 |
| 29 |
| Cough | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Dark urine | Renal and urinary disorders | Systematic Assessment |
|
| Flu | General disorders | Systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | Systematic Assessment |
|
| Fever | General disorders | Systematic Assessment |
|
| Strep infection | Infections and infestations | Systematic Assessment |
|
| Upper respiratory infection | Infections and infestations | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | Systematic Assessment |
|
| Loose stool | Gastrointestinal disorders | Systematic Assessment |
|
| Mononucleosis | General disorders | Systematic Assessment |
|
| Viral infection | Infections and infestations | Systematic Assessment |
|
| Scarlet fever | Infections and infestations | Systematic Assessment |
|
| Sinus infection | Infections and infestations | Systematic Assessment |
|
| Pneumonia | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Ear infection | Ear and labyrinth disorders | Systematic Assessment |
|
| Rash | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
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| Unknown or Not Reported |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| Communication - baseline |
|
| Communication - 6 month |
|
| Motor - baseline |
|
| Motor - 6 month |
|
| Daily - baseline |
|
| Daily - 6 month |
|
| Knowledge - baseline |
|
| Knowledge - 6 months |
|