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| ID | Type | Description | Link |
|---|---|---|---|
| Pro00102894 | Other Identifier | Duke IRB |
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| Name | Class |
|---|---|
| The Marcus Foundation | OTHER |
| Cryo-Cell International | UNKNOWN |
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The purpose of this Phase II study is to determine the efficacy of human umbilical cord tissue-derived mesenchymal stromal cells (hCT-MSC) for improving social communication abilities in children with autism spectrum disorder (ASD).
The purpose of this double blinded Phase II study is to determine the efficacy of human umbilical cord tissue-derived mesenchymal stromal cells (hCT-MSC), administered in two different dosing strategies, in children with autism spectrum disorder (ASD).
This study will be enrolling children with ASD, aging 4-11 years of age. Qualifying subjects will undergo neuropsychological evaluation, EEG testing, eye tracking, CVA assessments, and infusion of study product. Subjects will be randomized to one of two study arms; 1) a single infusion of 6.0x106 cells/Kg at baseline, followed by a blinded placebo infusion at six months or, 2) Placebo infusion at baseline, followed by an intravenous dose of 6x106 cells/Kg at six months. The second infusion was included primarily as an incentive to ensure that all participants ultimately receive an infusion of MSC, to reduce the risk of unblinding, and to encourage study completion. Efficacy outcome measures were only evaluated 6 months before the second infusion. Safety outcomes were assessed during the entire 12 months of the study.
The primary endpoint of this study is the change in social communication skill from baseline to six months. The potential risks associated with infusion of MSCs include a reaction to the product (rash, shortness of breath, wheezing, difficulty breathing, hypotension, swelling around the mouth, throat or eyes, tachycardia, diaphoresis), transmission of infection, and HLA sensitization.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| MSC | Experimental | One dose of 6x10e6 cells/kg administered intravenously. |
|
| Placebo Infusion | Placebo Comparator | Placebo infusion |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cord Tissue Mesenchymal Stromal Cells | Biological | Human Umbilical Cord Tissue Derived Mesenchymal Stromal Cells (hCT-MSC), isolated and expanded from umbilical cord tissue from allogeneic unrelated donors. One dose of 6x10e6 cells/kg administered intravenously. |
| Measure | Description | Time Frame |
|---|---|---|
| Change on the Average Socialization and Communication Subscale Standard Scores on the Vineland Behavior Scales (VABS-3) | The primary outcome measure is the mean of the Socialization and Communication Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form. The primary endpoint is the change in this outcome measure from baseline to six months before the second infusion. A positive change in the scores indicates an improvement in socialization and communication. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Baseline, 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in VABS-3 (Vineland Adaptive Behavior Scales) Socialization Standard Score | The change in the Socialization Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from baseline to six months. Higher Socialization Standard scores indicate greater socialization. A positive change in the scores indicates an improvement in socialization. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Experiencing an Infusion Reaction | To assess safety, participants were considered according to the treatment received at each time point, not what they were randomized. Patients received the infusion to which they were randomized at baseline and the alternate treatment at 6 months. Therefore, adverse events are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion). |
Inclusion Criteria
Exclusion Criteria
General:
Genetic:
Infectious:
Medical:
Current/Prior Therapy:
a. Availability of a banked, qualified autologous cord blood unit or parents deferred use of qualified, autologous cord blood unit b. History of prior cell therapy c. Current or prior use of IVIG or other anti-inflammatory medications with the exception of NSAIDs d. Current or prior immunosuppressive therapy i. No systemic steroid therapy that has lasted >2 weeks, and no systemic steroids within 3 months prior to enrollment. Topical and inhaled steroids are permitted.
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| Name | Affiliation | Role |
|---|---|---|
| Beth Shaz, MD | Duke University | Principal Investigator |
| Lauren Franz, MBChB | Duke University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Duke University Medical Center | Durham | North Carolina | 27705 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28941213 | Background | Chatham CH, Taylor KI, Charman T, Liogier D'ardhuy X, Eule E, Fedele A, Hardan AY, Loth E, Murtagh L, Del Valle Rubido M, San Jose Caceres A, Sevigny J, Sikich L, Snyder L, Tillmann JE, Ventola PE, Walton-Bowen KL, Wang PP, Willgoss T, Bolognani F. Adaptive behavior in autism: Minimal clinically important differences on the Vineland-II. Autism Res. 2018 Feb;11(2):270-283. doi: 10.1002/aur.1874. Epub 2017 Sep 21. |
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The second infusion was included primarily as an incentive to ensure that all participants ultimately receive an infusion of MSC, to reduce the risk of unblinding, and to encourage study completion. Efficacy outcome measures were only evaluated 6 months before the second infusion. Safety outcomes were assessed during the entire 12 months of the study.
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| ID | Title | Description |
|---|---|---|
| FG000 | MSC (Mesenchymal Stromal Cells) Infusion | Cord Tissue Mesenchymal Stromal Cells: Human Umbilical Cord Tissue Derived Mesenchymal Stromal Cells (hCT-MSC), isolated and expanded from umbilical cord tissue from allogeneic unrelated donors. One dose of 6x10e6 cells/kg was administered intravenously at baseline, and a placebo comparative infusion was administered intravenously after the 6-month outcome assessment. The second infusion was included primarily as an incentive to ensure that all participants ultimately receive an infusion of MSC, to reduce the risk of unblinding, and to encourage study completion. Efficacy outcome measures were only evaluated 6 months before the second infusion. Safety outcomes were assessed during the entire 12 months of the study. |
| FG001 | Placebo Infusion | Placebo comparative infusion was administered intravenously at baseline, and one dose of 6x10e6 cells/kg hCT-MSC was administered intravenously after the 6-month outcome assessment. The second infusion was included primarily as an incentive to ensure that all participants ultimately receive an infusion of MSC, to reduce the risk of unblinding, and to encourage study completion. Efficacy outcome measures were only evaluated 6 months before the second infusion. Safety outcomes were assessed during the entire 12 months of the study. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | MSC (Mesenchymal Stromal Cells) Infusion | Cord Tissue Mesenchymal Stromal Cells: Human Umbilical Cord Tissue Derived Mesenchymal Stromal Cells (hCT-MSC), isolated and expanded from umbilical cord tissue from allogeneic unrelated donors. One dose of 6x10e6 cells/kg was administered intravenously at baseline, and a placebo comparative infusion was administered intravenously after the 6-month outcome assessment. |
| 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 on the Average Socialization and Communication Subscale Standard Scores on the Vineland Behavior Scales (VABS-3) | The primary outcome measure is the mean of the Socialization and Communication Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form. The primary endpoint is the change in this outcome measure from baseline to six months before the second infusion. A positive change in the scores indicates an improvement in socialization and communication. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Two MSC patients were not able to be evaluated for the VABS-3 at 6 months and did not have 6 month scores collected. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
|
Up to 12 months. Adverse events are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion). 6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated.
To assess safety, participants were considered according to the treatment received at each time point, not what they were randomized. Patients received the infusion to which they were randomized at baseline, and the alternate treatment at 6 months as an incentive to ensure that all participants ultimately receive an infusion of MSC, to reduce the risk of unblinding, and to encourage study completion.
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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 | MSC (Mesenchymal Stromal Cells), First Infusion MSC, 0-6 Months | One dose of 6x10e6 cells/kg was administered intravenously at baseline for the MSC arm. Cord Tissue Mesenchymal Stromal Cells: Human Umbilical Cord Tissue Derived Mesenchymal Stromal Cells (hCT-MSC), isolated and expanded from umbilical cord tissue from allogeneic unrelated donors. One dose of 6x10e6 cells/kg was administered intravenously. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anxiety | Psychiatric disorders | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Eosinophilia | Blood and lymphatic system disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Joanne Kurtzberg, MD | Duke University | 919-668-1100 | joanne.kurtzberg@duke.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Feb 27, 2023 | May 1, 2024 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D001321 | Autistic Disorder |
| D000067877 | Autism Spectrum Disorder |
| ID | Term |
|---|---|
| D002659 | Child Development Disorders, Pervasive |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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This study is a phase II, prospective, randomized, blinded clinical trial designed to assess the efficacy of intravenous dosing of hCT-MSC for improving social communication abilities in young children with ASD. All participants will ultimately be treated with hCT-MSC. Participants randomized to arm A will each receive a single intravenous dose of 6x106 hCT-MSC per kilogram at baseline, followed by a placebo infusion at six months. Participants randomized to arm B will each receive a placebo infusion at baseline, followed by an intravenous dose of 6x106 hCT-MSC per kilogram at six months.
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Blinded infusion
| Placebo Infusion | Other | Placebo comparative infusion |
|
| Baseline, 6 months |
| Change in VABS-3 Communication Standard Score | The change in the Communication Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form from baseline to six months before the second infusion. Higher scores indicate greater communication. A positive change in the scores indicates an improvement in communication. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Baseline, 6 months |
| CGI-S (Clinical Global Impression - Severity of Illness) Overall Score | The CGI-S Overall Score is a 7-point scale that requires the clinician to rate the severity of the participant's overall functioning and symptoms of autism at the time of assessment, relative to the clinician's experience with participants who have the same diagnosis. The clinician rates the severity of autism symptoms - 1, normal, no symptoms; 2, borderline level of symptoms; 3, mild symptoms; 4, moderate symptoms; 5, marked symptoms; 6, severe symptoms; or 7, extremely severe symptoms. The higher ratings indicate greater severity of overall functioning impairment. | 6 months |
| CGI-I (Clinical Global Impression - Improvement) Overall Score | The CGI-I Overall Score is a 7-point scale that requires the clinician to assess how much the participant's autism overall functioning and symptoms have improved or worsened relative to a baseline assessment. The symptoms are rated as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse. The lower scores indicate greater improvement. | 6 months |
| Change in the Pediatric Quality of Life (PedsQL) Total Scale Score | The PedsQL 4.0 Generic Core Scales is a 5-minute parent questionnaire that measures the child's functioning in the dimensions of physical, emotional, social, and school. The items use a Likert rating scale from 0 (Never) to 4 (Almost Always). This 0-4 scale is then transformed to 0=100, 1=75, 2=50, 3=25, and 4=0 for a reverse score. The Total Scale Score is then computed as the sum of all the items over the number of items answered on all the Scales for a total score range of 0 to 100. Higher scores indicate a better quality of life. | Baseline, 6 months |
| up to 12 months |
| Number of Participants Experiencing Product-related Infections | To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized. Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months. AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion). 6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated. | up to 12 months |
| Evidence of Formation of Anti-HLA Antibodies | Assess for anti-HLA antibodies | Baseline, 6 months, 12 months |
| Number of Participants Experiencing Graft Versus Host Disease (GVHD) | To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized. Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months. AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion). 6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated. | up to 12 months |
| Number of Participants Experiencing Unexpected Adverse Events Related to the Study Product | To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized. Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months. AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion). 6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated. | up to 12 months |
| Change on the Adaptive Behavior Composite Subscale Standard Score on the Vineland Behavior Scales (VABS-3) | The change in the Vineland Adaptive Behavior Scales (VABS-3) Adaptive Behavior Composite Subscale from baseline to 6 months before the second infusion. Higher Adaptive Behavior Composite Standard scores indicate greater adaptive behavior. A positive change in the scores indicates an improvement in adaptive behavior. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Baseline, 6 months |
| Change in VABS-3 (Vineland Adaptive Behavior Scales) Daily Living Skills Standard Score | The change in the Daily Living Skills Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from baseline to six months before the second infusion. Higher Daily Living Skills Standard scores indicate greater daily living skills. A positive change in the scores indicates an improvement in daily living skills. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Baseline, 6 months |
| Change in VABS-3 Motor Skills Standard Score | The change in the Motor Skills Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form from baseline to six months before the second infusion. Higher scores indicate greater motor skills. A positive change in the scores indicates an improvement in motor skills. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Baseline, 6 months |
| Change in Aberrant Behavior Checklist-Community (ABC-C) Social Withdrawal | The change in the Aberrant Behavior Checklist-Community (ABC-C) Social Withdrawal scale from baseline to six months before the second infusion. Higher scores indicate greater problems with social withdrawal. A positive change in the scores indicates a worsening in social withdrawal. This scale has 16 items that are scored on a 4-point Likert scale: 0 = not a problem, 1 = slight problem, 2 = moderately serious problem, 3 = severe problem. The individual items are added together to calculate the Social Withdrawal scale score. | Baseline, 6 months |
| Change in Pervasive Developmental Disorder Behavior Inventory (PDDBI) Total Score | The change in the Pervasive Developmental Disorder Behavior Inventory (PDDBI) from baseline to 6 months before the second infusion. The PDDBI is a measure of problem behaviors and social, language, and learning or memory skills of children who have been diagnosed with autism spectrum disorder. Raw scores are converted to T-scores. The T-score has a mean of 50 with a standard deviation of 10 points with a range of 10-100. Higher scores indicate greater behavioral issues and a positive change in score indicates worsening. | Baseline, 6 months |
| Change in the Autism Impact Measure (AIM) | The change in the Autism Impact Measure (AIM) from baseline to 6 months before second infusion. AIM is a measure of core Autism Spectrum Disorder Symptoms. It is a parent-report questionnaire that includes 41 core-symptom items rated on two corresponding 5-point scales: frequency (ranging from "never" to "always") and impact (ranging from "not at all" to "severely") over the previous two weeks. Frequency and impact ratings are combined, yielding a total score range of 82 to 410. Higher scores indicate greater symptom severity; a positive change in score indicates worsening of symptoms. | Baseline, 6 months |
| Change in the Behavior Rating Inventory of Executive Function (BRIEF) Emotional Control Subscale | The change in the Behavior Rating Inventory of Executive Function (BRIEF) Emotional Control subscale from baseline to month 6 before the second infusion. BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization. Higher scores indicate greater levels of dysfunction each respective domain. A positive change in score indicates worsening the respective domain. Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles. T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated. | Baseline, 6 months |
| Change in the Behavior Rating Inventory of Executive Function (BRIEF) Working Memory Subscale | The change in the Behavior Rating Inventory of Executive Function (BRIEF) Working Memory subscale from baseline to month 6 before the second infusion. The BREIF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization. Higher scores indicate greater levels of dysfunction each respective domain. A positive change in score indicates worsening the respective domain. Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles. T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated. | Baseline, 6 months |
| Change in the Behavior Rating Inventory of Executive Function (BRIEF) Inhibit Subscale | The change in the Behavior Rating Inventory of Executive Function (BRIEF) Inhibit subscale from baseline to month 6 before the second infusion. The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization. Higher scores indicate greater levels of dysfunction each respective domain. A positive change in score indicates worsening the respective domain. Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles. T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated. | Baseline, 6 months |
| Change in the Behavior Rating Inventory of Executive Function (BRIEF) Plan/Organization Subscale | The change in the Behavior Rating Inventory of Executive Function (BRIEF) Plan/Organization subscale from baseline to month 6 before the second infusion. The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization. Higher scores indicate greater levels of dysfunction each respective domain. A positive change in score indicates worsening the respective domain. Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles. T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated. | Baseline, 6 months |
| Change in the Behavior Rating Inventory of Executive Function (BRIEF) Shift Subscale | The change in the Behavior Rating Inventory of Executive Function (BRIEF) Shift subscale from baseline to month 6 before the second infusion. The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization. Higher scores indicate greater levels of dysfunction each respective domain. A positive change in score indicates worsening the respective domain. Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles. T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated. | Baseline, 6 months |
| Change in the Expressive Vocabulary Test (Third Edition, EVT-3) | The change in the Expressive Vocabulary Test (Third Edition, EVT-3) from baseline to 6 months before the second infusion. The EVT-3 is a measure of a participant's ability to match a spoken word with an image of an object, action, or concept. The number of words that are retrieved is converted to a Standard Score, where 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. A positive change in EVT-3 score indicates improvement. | Baseline, 6 months |
| BG001 | Placebo Infusion | Placebo comparative infusion was administered intravenously at baseline, and one dose of 6x10e6 cells/kg hCT-MSC was administered intravenously after the 6-month outcome assessment. |
| 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 | Count of Participants | Participants |
|
| Description |
|---|
| OG000 | MSC (Mesenchymal Stromal Cells) Infusion | Cord Tissue Mesenchymal Stromal Cells: Human Umbilical Cord Tissue Derived Mesenchymal Stromal Cells (hCT-MSC), isolated and expanded from umbilical cord tissue from allogeneic unrelated donors. One dose of 6x10e6 cells/kg was administered intravenously at baseline, and a placebo comparative infusion was administered intravenously after the 6-month outcome assessment. The second infusion was included primarily as an incentive to ensure that all participants ultimately receive an infusion of MSC, to reduce the risk of unblinding, and to encourage study completion. Efficacy outcome measures were only evaluated 6 months before the second infusion. Safety outcomes were assessed during the entire 12 months of the study. |
| OG001 | Placebo Infusion | Placebo comparative infusion was administered intravenously at baseline, and one dose of 6x10e6 cells/kg hCT-MSC was administered intravenously after the 6-month outcome assessment. The second infusion was included primarily as an incentive to ensure that all participants ultimately receive an infusion of MSC, to reduce the risk of unblinding, and to encourage study completion. Efficacy outcome measures were only evaluated 6 months before the second infusion. Safety outcomes were assessed during the entire 12 months of the study. |
|
|
|
| Secondary | Change in VABS-3 (Vineland Adaptive Behavior Scales) Socialization Standard Score | The change in the Socialization Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from baseline to six months. Higher Socialization Standard scores indicate greater socialization. A positive change in the scores indicates an improvement in socialization. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Two MSC patients could not be evaluated for the VABS-3 at 6 months and did not have 6 months scores collected. | Posted | Least Squares Mean | Standard Error | units on a scale | Baseline, 6 months |
|
|
|
|
| Secondary | Change in VABS-3 Communication Standard Score | The change in the Communication Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form from baseline to six months before the second infusion. Higher scores indicate greater communication. A positive change in the scores indicates an improvement in communication. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Two MSC patients could not be evaluated for the VABS-3 at 6 months and did not have 6 months scores collected. | Posted | Least Squares Mean | Standard Error | units on a scale | Baseline, 6 months |
|
|
|
|
| Secondary | CGI-S (Clinical Global Impression - Severity of Illness) Overall Score | The CGI-S Overall Score is a 7-point scale that requires the clinician to rate the severity of the participant's overall functioning and symptoms of autism at the time of assessment, relative to the clinician's experience with participants who have the same diagnosis. The clinician rates the severity of autism symptoms - 1, normal, no symptoms; 2, borderline level of symptoms; 3, mild symptoms; 4, moderate symptoms; 5, marked symptoms; 6, severe symptoms; or 7, extremely severe symptoms. The higher ratings indicate greater severity of overall functioning impairment. | Two MSC patients and one placebo patient were not evaluated for CGI-S at 6 months. | Posted | Median | Inter-Quartile Range | score on a scale | 6 months |
|
|
|
|
| Secondary | CGI-I (Clinical Global Impression - Improvement) Overall Score | The CGI-I Overall Score is a 7-point scale that requires the clinician to assess how much the participant's autism overall functioning and symptoms have improved or worsened relative to a baseline assessment. The symptoms are rated as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse. The lower scores indicate greater improvement. | Two MSC patients and one placebo patient were not evaluated for CGI-I at 6 months. | Posted | Median | Inter-Quartile Range | score on a scale | 6 months |
|
|
|
|
| Secondary | Change in the Pediatric Quality of Life (PedsQL) Total Scale Score | The PedsQL 4.0 Generic Core Scales is a 5-minute parent questionnaire that measures the child's functioning in the dimensions of physical, emotional, social, and school. The items use a Likert rating scale from 0 (Never) to 4 (Almost Always). This 0-4 scale is then transformed to 0=100, 1=75, 2=50, 3=25, and 4=0 for a reverse score. The Total Scale Score is then computed as the sum of all the items over the number of items answered on all the Scales for a total score range of 0 to 100. Higher scores indicate a better quality of life. | Two MSC patients and one placebo patient were not evaluated for PedsQL at 6 months. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
|
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| Other Pre-specified | Number of Participants Experiencing an Infusion Reaction | To assess safety, participants were considered according to the treatment received at each time point, not what they were randomized. Patients received the infusion to which they were randomized at baseline and the alternate treatment at 6 months. Therefore, adverse events are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion). | Three MSC patients and one Placebo patient did not receive the 6-month infusion and were not included in the evaluation. | Posted | Count of Participants | Participants | up to 12 months |
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| Other Pre-specified | Number of Participants Experiencing Product-related Infections | To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized. Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months. AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion). 6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated. | Posted | Count of Participants | Participants | up to 12 months |
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| Other Pre-specified | Evidence of Formation of Anti-HLA Antibodies | Assess for anti-HLA antibodies | Not Posted | Baseline, 6 months, 12 months | Participants |
| Other Pre-specified | Number of Participants Experiencing Graft Versus Host Disease (GVHD) | To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized. Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months. AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion). 6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated. | Posted | Count of Participants | Participants | up to 12 months |
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| Other Pre-specified | Number of Participants Experiencing Unexpected Adverse Events Related to the Study Product | To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized. Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months. AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion). 6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated. | Posted | Count of Participants | Participants | up to 12 months |
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| Other Pre-specified | Change on the Adaptive Behavior Composite Subscale Standard Score on the Vineland Behavior Scales (VABS-3) | The change in the Vineland Adaptive Behavior Scales (VABS-3) Adaptive Behavior Composite Subscale from baseline to 6 months before the second infusion. Higher Adaptive Behavior Composite Standard scores indicate greater adaptive behavior. A positive change in the scores indicates an improvement in adaptive behavior. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Two MSC patients were not able to be evaluated for the VABS-3 at 6 months and did not have 6-month scores collected. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
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| Other Pre-specified | Change in VABS-3 (Vineland Adaptive Behavior Scales) Daily Living Skills Standard Score | The change in the Daily Living Skills Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from baseline to six months before the second infusion. Higher Daily Living Skills Standard scores indicate greater daily living skills. A positive change in the scores indicates an improvement in daily living skills. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Two MSC patients could not be evaluated for the VABS-3 at 6 months and did not have 6 months scores collected. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
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| Other Pre-specified | Change in VABS-3 Motor Skills Standard Score | The change in the Motor Skills Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form from baseline to six months before the second infusion. Higher scores indicate greater motor skills. A positive change in the scores indicates an improvement in motor skills. A standard score of 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. | Two MSC patients could not be evaluated for the VABS-3 at 6 months and did not have 6 months scores collected. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
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| Other Pre-specified | Change in Aberrant Behavior Checklist-Community (ABC-C) Social Withdrawal | The change in the Aberrant Behavior Checklist-Community (ABC-C) Social Withdrawal scale from baseline to six months before the second infusion. Higher scores indicate greater problems with social withdrawal. A positive change in the scores indicates a worsening in social withdrawal. This scale has 16 items that are scored on a 4-point Likert scale: 0 = not a problem, 1 = slight problem, 2 = moderately serious problem, 3 = severe problem. The individual items are added together to calculate the Social Withdrawal scale score. | Two MSC patients were not evaluated for the ABC-C Social Withdrawal Score at 6 months. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
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| Other Pre-specified | Change in Pervasive Developmental Disorder Behavior Inventory (PDDBI) Total Score | The change in the Pervasive Developmental Disorder Behavior Inventory (PDDBI) from baseline to 6 months before the second infusion. The PDDBI is a measure of problem behaviors and social, language, and learning or memory skills of children who have been diagnosed with autism spectrum disorder. Raw scores are converted to T-scores. The T-score has a mean of 50 with a standard deviation of 10 points with a range of 10-100. Higher scores indicate greater behavioral issues and a positive change in score indicates worsening. | Two MSC patients were not evaluated for PDDBI at 6 months. | Posted | Least Squares Mean | Standard Error | T-score | Baseline, 6 months |
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| Other Pre-specified | Change in the Autism Impact Measure (AIM) | The change in the Autism Impact Measure (AIM) from baseline to 6 months before second infusion. AIM is a measure of core Autism Spectrum Disorder Symptoms. It is a parent-report questionnaire that includes 41 core-symptom items rated on two corresponding 5-point scales: frequency (ranging from "never" to "always") and impact (ranging from "not at all" to "severely") over the previous two weeks. Frequency and impact ratings are combined, yielding a total score range of 82 to 410. Higher scores indicate greater symptom severity; a positive change in score indicates worsening of symptoms. | Two MSC patients were not evaluated for AIM at 6 months. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
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| Other Pre-specified | Change in the Behavior Rating Inventory of Executive Function (BRIEF) Emotional Control Subscale | The change in the Behavior Rating Inventory of Executive Function (BRIEF) Emotional Control subscale from baseline to month 6 before the second infusion. BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization. Higher scores indicate greater levels of dysfunction each respective domain. A positive change in score indicates worsening the respective domain. Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles. T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated. | Two MSC patients and one Placebo patient were not evaluated for BRIEF Emotional Control at 6 months. | Posted | Least Squares Mean | Standard Error | T-score | Baseline, 6 months |
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| Other Pre-specified | Change in the Behavior Rating Inventory of Executive Function (BRIEF) Working Memory Subscale | The change in the Behavior Rating Inventory of Executive Function (BRIEF) Working Memory subscale from baseline to month 6 before the second infusion. The BREIF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization. Higher scores indicate greater levels of dysfunction each respective domain. A positive change in score indicates worsening the respective domain. Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles. T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated. | Two MSC patients and one Placebo patient were not evaluated for BRIEF Working memory at 6 months. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
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| Other Pre-specified | Change in the Behavior Rating Inventory of Executive Function (BRIEF) Inhibit Subscale | The change in the Behavior Rating Inventory of Executive Function (BRIEF) Inhibit subscale from baseline to month 6 before the second infusion. The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization. Higher scores indicate greater levels of dysfunction each respective domain. A positive change in score indicates worsening the respective domain. Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles. T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated. | Two MSC patients and one Placebo patient were not evaluated for BRIEF Inhibit at 6 months. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
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| Other Pre-specified | Change in the Behavior Rating Inventory of Executive Function (BRIEF) Plan/Organization Subscale | The change in the Behavior Rating Inventory of Executive Function (BRIEF) Plan/Organization subscale from baseline to month 6 before the second infusion. The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization. Higher scores indicate greater levels of dysfunction each respective domain. A positive change in score indicates worsening the respective domain. Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles. T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated. | Two MSC patients and one Placebo patient were not evaluated for BRIEF Plan/Organization at 6 months. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
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| Other Pre-specified | Change in the Behavior Rating Inventory of Executive Function (BRIEF) Shift Subscale | The change in the Behavior Rating Inventory of Executive Function (BRIEF) Shift subscale from baseline to month 6 before the second infusion. The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization. Higher scores indicate greater levels of dysfunction each respective domain. A positive change in score indicates worsening the respective domain. Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles. T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated. | Two MSC patients and one Placebo patient were not evaluated for BRIEF Shift at 6 months. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
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| Other Pre-specified | Change in the Expressive Vocabulary Test (Third Edition, EVT-3) | The change in the Expressive Vocabulary Test (Third Edition, EVT-3) from baseline to 6 months before the second infusion. The EVT-3 is a measure of a participant's ability to match a spoken word with an image of an object, action, or concept. The number of words that are retrieved is converted to a Standard Score, where 100 is the mean with a standard deviation of 15 points. A score of 100 should be understood as being similar to the typical population of the same age. Scores greater than or equal to 86 are considered adequate or above adequate. Scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers. A positive change in EVT-3 score indicates improvement. | Two MSC patients and two Placebo patients were not evaluated for EVT-3 at 6 months. | Posted | Least Squares Mean | Standard Error | score on a scale | Baseline, 6 months |
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| Post-Hoc | Percentage of Responders Achieving an Improvement in VABS-3 2DC ≥3.1 | The percentage of responders achieving an improvement in VABS-3 2DC ≥3.1 (the minimal clinically important difference, MCID) from baseline to 6 months along with the corresponding 95% CI are presented. The percentage of responders and the 2-sided CI were estimated from a modified Poisson model adjusting for treatment indicator, baseline VABS-2 2DC score, IQ strata, and age strata. The MCID estimates are from Chatham et al. (2018; PMID: 28941213) | Two MSC patients were not evaluated for the VABS-3 2DC at 6 months. | Posted | Number | 95% Confidence Interval | percentage of participants | Baseline, 6 months |
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| Post-Hoc | Percentage of Responders Achieving an Improvement in VABS-3 Communication Subscale ≥3.1 | The percentage of responders achieving an improvement in VABS-3 communication subscale ≥3.1 (the minimal clinically important difference, MCID) from baseline to 6 months along with the corresponding 95% CI are presented. The percentage of responders and the 2-sided CI were estimated from a modified Poisson model adjusting for treatment indicator, baseline VABS-2 communication score, IQ strata, and age strata. The MCID estimates are from Chatham et al. (2018; PMID: 28941213) | Two MSC patients were not evaluated for the VABS-3 Communication Subscale at 6 months. | Posted | Number | 95% Confidence Interval | percentage of participants | Baseline, 6 months |
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| Post-Hoc | Percentage of Responders Achieving an Improvement in VABS-3 Socialization Subscale ≥3.1 | The percentage of responders achieving an improvement in VABS-3 socialization subscale ≥3.1 (the minimal clinically important difference, MCID) from baseline to 6 months along with the corresponding 95% CI are presented. The percentage of responders and the 2-sided CI were estimated from a modified Poisson model adjusting for treatment indicator, baseline VABS-2 socialization score, IQ strata, and age strata. The MCID estimates are from Chatham et al. (2018; PMID: 28941213) | Two MSC patients were not evaluated for the VABS-3 Socialization Subscale at 6 months. | Posted | Number | 95% Confidence Interval | percentage of participants | Up to 6 months |
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| 0 |
| 68 |
| 1 |
| 68 |
| 53 |
| 68 |
| EG001 | Placebo, First Infusion Placebo, 0-6 Months | Placebo infusion was administered intravenously at baseline for the Placebo arm. Placebo Infusion: Placebo comparative infusion | 0 | 69 | 0 | 69 | 40 | 69 |
| EG002 | MSC (Mesenchymal Stromal Cells), Received Second Infusion Placebo, 6-12 Months | Placebo infusion was administered intravenously at 6 months for the MSC arm as an incentive. | 0 | 65 | 0 | 65 | 39 | 65 |
| EG003 | MSC (Mesenchymal Stromal Cells), Did Not Receive Second Infusion Placebo, 6-12 Months | Placebo infusion was not administered, but patients were followed up from 6-12 months post-baseline infusion | 0 | 3 | 0 | 3 | 1 | 3 |
| EG004 | Placebo, Received Second Infusion MSC, 6-12 Months | One dose of 6x10e6 cells/kg was administered intravenously at 6 months for the Placebo arm as an incentive. Cord Tissue Mesenchymal Stromal Cells: Human Umbilical Cord Tissue Derived Mesenchymal Stromal Cells (hCT-MSC), isolated and expanded from umbilical cord tissue from allogeneic unrelated donors. One dose of 6x10e6 cells/kg was administered intravenously. | 0 | 68 | 1 | 68 | 48 | 68 |
| EG005 | Placebo, Did Not Receive Second Infusion MSC, 6-12 Months | hCT-MSC infusion was not administered, but patients were followed up from 6-12 months post-baseline infusion | 0 | 1 | 0 | 1 | 0 | 1 |
| Seizure | Nervous system disorders | Non-systematic Assessment |
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| Sinus tachycardia | Cardiac disorders | Non-systematic Assessment |
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| Ear pain | Ear and labyrinth disorders | Non-systematic Assessment |
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| Hypothyroidism | Endocrine disorders | Non-systematic Assessment |
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| Eye disorders - Other, specify | Eye disorders | Non-systematic Assessment |
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| Eye pain | Eye disorders | Non-systematic Assessment |
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| Vision decreased | Eye disorders | Non-systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | Non-systematic Assessment |
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| Constipation | Gastrointestinal disorders | Non-systematic Assessment |
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| Dental caries | Gastrointestinal disorders | Non-systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | Non-systematic Assessment |
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| Fecal incontinence | Gastrointestinal disorders | Non-systematic Assessment |
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| Gastrointestinal disorders - Other, specify | Gastrointestinal disorders | Non-systematic Assessment |
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| Tooth development disorder | Gastrointestinal disorders | Non-systematic Assessment |
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| Vomiting | Gastrointestinal disorders | Non-systematic Assessment |
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| Fatigue | General disorders | Non-systematic Assessment |
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| Fever | General disorders | Non-systematic Assessment |
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| Flu like symptoms | General disorders | Non-systematic Assessment |
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| Injection site reaction | General disorders | Non-systematic Assessment |
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| Pain | General disorders | Non-systematic Assessment |
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| Allergic reaction | Immune system disorders | Non-systematic Assessment |
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| Conjunctivitis | Infections and infestations | Non-systematic Assessment |
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| Infections and Infestations | Infections and infestations | Non-systematic Assessment |
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| Infections and infestations - Other, specify | Infections and infestations | Non-systematic Assessment |
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| Laryngitis | Infections and infestations | Non-systematic Assessment |
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| Mucosal infection | Infections and infestations | Non-systematic Assessment |
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| Otitis media | Infections and infestations | Non-systematic Assessment |
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| Pharyngitis | Infections and infestations | Non-systematic Assessment |
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| Sinusitis | Infections and infestations | Non-systematic Assessment |
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| Skin infection | Infections and infestations | Non-systematic Assessment |
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| Upper respiratory infection | Infections and infestations | Non-systematic Assessment |
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| Bruising | Injury, poisoning and procedural complications | Non-systematic Assessment |
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| Fracture | Injury, poisoning and procedural complications | Non-systematic Assessment |
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| Infusion related reaction | Injury, poisoning and procedural complications | Non-systematic Assessment |
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| Injury, Poisoning and Procedural Complications | Injury, poisoning and procedural complications | Non-systematic Assessment |
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| Wound complication | Injury, poisoning and procedural complications | Non-systematic Assessment |
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| Cholesterol high | Investigations | Non-systematic Assessment |
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| Neutrophil count decreased | Investigations | Non-systematic Assessment |
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| Weight gain | Investigations | Non-systematic Assessment |
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| Anorexia | Metabolism and nutrition disorders | Non-systematic Assessment |
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| Metabolism and nutrition disorders - Other, specify | Metabolism and nutrition disorders | Non-systematic Assessment |
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| Pain in extremity | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Dizziness | Nervous system disorders | Non-systematic Assessment |
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| Headache | Nervous system disorders | Non-systematic Assessment |
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| Nervous system disorders - Other, specify | Nervous system disorders | Non-systematic Assessment |
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| Seizure | Nervous system disorders | Non-systematic Assessment |
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| Aggression | Psychiatric disorders | Non-systematic Assessment |
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| Agitation | Psychiatric disorders | Non-systematic Assessment |
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| Anxiety | Psychiatric disorders | Non-systematic Assessment |
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| Confusion | Psychiatric disorders | Non-systematic Assessment |
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| Decreased Motivation | Psychiatric disorders | Non-systematic Assessment |
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| Defiance | Psychiatric disorders | Non-systematic Assessment |
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| Emotionality | Psychiatric disorders | Non-systematic Assessment |
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| Hyperactivity | Psychiatric disorders | Non-systematic Assessment |
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| Impulsivity | Psychiatric disorders | Non-systematic Assessment |
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| Inattention | Psychiatric disorders | Non-systematic Assessment |
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| Increased Aggression | Psychiatric disorders | Non-systematic Assessment |
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| Increased Agitation | Psychiatric disorders | Non-systematic Assessment |
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| Increased Anxiety | Psychiatric disorders | Non-systematic Assessment |
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| Increased Emotionality | Psychiatric disorders | Non-systematic Assessment |
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| Increased Frustration | Psychiatric disorders | Non-systematic Assessment |
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| Increased Hyperactivity | Psychiatric disorders | Non-systematic Assessment |
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| Increased Irritability | Psychiatric disorders | Non-systematic Assessment |
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| Increased Meltdowns | Psychiatric disorders | Non-systematic Assessment |
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| Increased Repetitive Behaviors | Psychiatric disorders | Non-systematic Assessment |
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| Increased Repetitive Language | Psychiatric disorders | Non-systematic Assessment |
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| Increased Sadness | Psychiatric disorders | Non-systematic Assessment |
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| Increased Self-Injurious Behavior | Psychiatric disorders | Non-systematic Assessment |
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| Increased Sensory Aversions | Psychiatric disorders | Non-systematic Assessment |
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| Increased Sensory Seeking Behaviors | Psychiatric disorders | Non-systematic Assessment |
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| Increased Sleep Difficulty | Psychiatric disorders | Non-systematic Assessment |
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| Insomnia | Psychiatric disorders | Non-systematic Assessment |
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| Irritability | Psychiatric disorders | Non-systematic Assessment |
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| Meltdowns | Psychiatric disorders | Non-systematic Assessment |
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| Noncompliance | Psychiatric disorders | Non-systematic Assessment |
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| Other | Psychiatric disorders | Non-systematic Assessment |
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| Repetitive Behaviors | Psychiatric disorders | Non-systematic Assessment |
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| Repetitive Language | Psychiatric disorders | Non-systematic Assessment |
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| Restlessness | Psychiatric disorders | Non-systematic Assessment |
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| Ritualistic Behaviors | Psychiatric disorders | Non-systematic Assessment |
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| Sadness | Psychiatric disorders | Non-systematic Assessment |
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| Self-Injury | Psychiatric disorders | Non-systematic Assessment |
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| Sensory Aversions | Psychiatric disorders | Non-systematic Assessment |
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| Sensory Seeking Behaviors | Psychiatric disorders | Non-systematic Assessment |
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| Sensory Sensitivity | Psychiatric disorders | Non-systematic Assessment |
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| Sleep Difficulty | Psychiatric disorders | Non-systematic Assessment |
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| Tic | Psychiatric disorders | Non-systematic Assessment |
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| Withdrawn | Psychiatric disorders | Non-systematic Assessment |
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| Urinary frequency | Renal and urinary disorders | Non-systematic Assessment |
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| Urinary incontinence | Renal and urinary disorders | Non-systematic Assessment |
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| Urinary tract pain | Renal and urinary disorders | Non-systematic Assessment |
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| Testicular pain | Reproductive system and breast disorders | Non-systematic Assessment |
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| Allergic rhinitis | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Epistaxis | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Sore throat | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Eczema | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Rash acneiform | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Rash maculo-papular | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
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| Surgical and Medical Procedures | Surgical and medical procedures | Non-systematic Assessment |
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| Flushing | Vascular disorders | Non-systematic Assessment |
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| Hypertension | Vascular disorders | Non-systematic Assessment |
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Not provided
Not provided
Not provided