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| ID | Type | Description | Link |
|---|---|---|---|
| 16/HĐ-K2ĐT | Other Grant/Funding Number | ministry of health |
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This study evaluates the safety and preliminary efficacy of autologous bone marrow mononuclear cell transplantation combined with rehabilitation in children with neurological sequelae caused by hypoxic-ischemic brain injury or intracranial hemorrhage. Participants in the intervention group will receive autologous bone marrow aspiration, mononuclear cell transplantation via intrathecal route, and rehabilitation, while the control group will receive rehabilitation alone. Outcomes will be compared between groups over follow-up time points.
Neurological sequelae following hypoxic-ischemic brain injury and intracranial hemorrhage in children remain a major clinical challenge with limited effective treatment options. Rehabilitation is the current standard of care but often results in incomplete recovery. Autologous bone marrow mononuclear cell transplantation has emerged as a promising therapeutic approach due to its potential neuroregenerative and neuroprotective effects. This phase II study aims to evaluate the safety and preliminary efficacy of combining autologous bone marrow mononuclear cell transplantation with rehabilitation compared to rehabilitation alone. The study will also contribute to the development of a standardized technical protocol for this intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| BMMNC Transplantation Plus Rehabilitation | Experimental | Participants receive autologous bone marrow mononuclear cell transplantation via intrathecal administration combined with rehabilitation. |
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| Rehabilitation Alone | No Intervention | Participants receive rehabilitation without cell transplantation. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Autologous Bone Marrow Mononuclear Cell Transplantation | Procedure | Autologous bone marrow mononuclear cells (BMMNCs) are collected from the patient's iliac crest under sterile conditions. Bone marrow aspiration is performed under appropriate anesthesia, followed by processing to isolate mononuclear cells using density gradient centrifugation. The prepared BMMNCs are administered via intrathecal injection under aseptic conditions. The dosage of cells is determined based on body weight and viability criteria. Patients are monitored for immediate and delayed adverse events following transplantation. In addition to cell transplantation, participants receive standardized rehabilitation therapy, including physical therapy, occupational therapy, and neurodevelopmental interventions, according to institutional protocols. This combined intervention aims to enhance neurological recovery through both regenerative cellular therapy and functional rehabilitation. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Gross Motor Function Measure (GMFM-88) total score from baseline to 12 months | Gross motor function will be assessed using the Gross Motor Function Measure (GMFM-88), a validated and standardized clinical scale for evaluating motor function in children with neurological impairment. The primary outcome is the change in GMFM-88 total score from baseline to 12 months. The change in score will be calculated and compared between the intervention group (autologous bone marrow mononuclear cell transplantation plus rehabilitation) and the control group (rehabilitation alone). | Baseline and 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in GMFM score at 3, 6, 9 months | Gross motor function will be assessed using the Gross Motor Function Measure (GMFM-88), a standardized clinical tool for children with cerebral palsy and related neurological impairment. The change in GMFM-88 total score from baseline to 3, 6,9 months will be calculated and compared between the intervention and control groups. | Baseline and 3, 6, 9 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| DAT HUU TRAN | Contact | +84987836686 | drtrandat1986@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Vietnam National Children's Hospital | Recruiting | Hanoi | Hanoi | 111111 | Vietnam |
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| Label | URL |
|---|---|
| Related Info | View source |
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Individual participant data (IPD) that underlie the results reported in this study will be shared after de-identification. Data will be available beginning 6 months following publication and ending 3 years after publication. Data will be shared with researchers who provide a methodologically sound proposal, for the purpose of achieving aims in the approved proposal. Proposals should be directed to the corresponding investigator. Data access will be provided after approval by the study team and institutional review board.
Data will be available beginning 6 months following publication of the primary results and ending 3 years after publication.
Access to de-identified individual participant data and supporting documents will be provided to qualified researchers who submit a methodologically sound proposal. Proposals should be directed to the corresponding investigator. Data access will be granted following review and approval by the study team and the institutional review board. A data use agreement may be required.
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| Change in Gross Motor Function Classification System (GMFCS) level from baseline to 12 months | Gross motor function classification will be assessed using the Gross Motor Function Classification System (GMFCS), which categorizes motor function based on self-initiated movement abilities, particularly sitting and mobility. Changes in GMFCS level from baseline to 12 months will be evaluated and compared between the intervention and control groups. | Baseline and 12 months |
| Change in Manual Ability Classification System (MACS or Mini-MACS) level from baseline to 12 months | Manual ability will be assessed using the Manual Ability Classification System (MACS) or Mini-MACS depending on the child's age. Changes in manual ability level from baseline to 12 months will be evaluated and compared between the intervention and control groups. | Baseline and 12 months |
| Incidence of transplantation-related adverse events | Adverse events related to bone marrow aspiration, anesthesia, intrathecal transplantation, and follow-up will be recorded. These include local pain at the aspiration site, low back pain after transplantation, fever, irritability, vomiting, rash, and other procedure-related complications. The incidence and severity of adverse events will be monitored and summarized throughout the study. | From intervention through 12 months follow-up |
| ID | Term |
|---|---|
| D012046 | Rehabilitation |
| ID | Term |
|---|---|
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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