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Autologous Stem Cells for Spinal Cord Injury (SCI) in Children

Primary Purpose

Spinal Cord Injury

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
bone marrow progenitor cells (BMPC) autologous transplantation
Sponsored by
James E.Baumgartner, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spinal Cord Injury focused on measuring Autologous, Stem Cells, Spinal Cord Injury, Children

Eligibility Criteria

1 Year - 15 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Between 1 year and 15 years of age on the day of study BMPC infusion.
  2. Survived at least six months with PSCI, but are less than 4 years post injury (± 30 days), and have fixed neurologic deficits related to their injury at the time of enrollment.
  3. Ability of child to understand and speak English.
  4. Ability of child and caregiver to travel to Houston, Texas, and stay for at least 4 days, and to return for all Follow-up visits (patient is responsible for cost of travel and lodging while in Houston).
  5. Pediatric patients with any type of spinal cord injury as long as their spinal cords are continuous on MRI evaluation. This includes paraplegic and quadriplegic patients with complete or incomplete spinal cord injuries. This includes patients with ASIA impairment scales from A to D. The clinical classification will be described by the level below which motor/sensory function is impaired, and the degree of that impairment. (i.e. C-5 if the deltoid muscle is intact but the biceps and other muscle groups below the C-5 level are weak [incomplete motor injury] or paralyzed [complete motor injury]. A similar evaluation of sensory function will be established clinically.

Exclusion Criteria:

  1. Lack of informed consent.
  2. Uncorrected coagulopathy during the baseline period defined as: INR > 1.4; PTT > 35 sec; PLT < 100,000.
  3. Pre-injury history of seizure disorder and/or neurological impairment where the patient would not be able to participate in age appropriate pain rating scales.
  4. A history of prior SCI or severe traumatic brain injury.
  5. Known history of:

    • Recently diagnosed infection (within past 2 weeks) requiring treatment and/or medical intervention.
    • Renal disease or altered renal function as defined by serum creatinine > 1.5 mg/dL.
    • Hepatic disease or altered liver function as defined by SGPT > 150 U/L, and/or T. Bilirubin > 1.3 mg/dL.
    • Malignancy.
    • Immunosuppression as defined by WBC < 3 (10x3) at screening and/or baseline evaluation lab.
    • HIV.
    • Hepatitis B or C.

8. Unhealed fractures or wounds including osteomyelitis.

9. Pneumonia, or chronic lung disease requiring oxygen.

10. An anatomically discontinuous spinal cord diagnosed by CT or MRI imaging.

11. Positive urine pregnancy test (urine pregnancy test will be routinely performed on females of childbearing potential, age 11 or older.

12. Participation in a concurrent intervention study.

13. Desire for organ-donation in the event of death.

14. Unwillingness or inability to stay for at least four days following BMPC infusion (should any problems arise following the infusion) and to return for a 30 day, and 6 month follow-up visit, and be available for 1 year, and 2 year follow-up phone calls.

Sites / Locations

  • Children's Memorial Hemann Hospital; University of Texas Health Science Center - Houston

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Biologic; Stem Cells

Arm Description

Outcomes

Primary Outcome Measures

American Spinal Injury Association (ASIA) - Standard Neurological Classification of Spinal Cord Injury.
ASIA classification assessment will take place pre-procedure, 1 day, 30 days, and 180 days post-procedure to define changes in functional outcome.

Secondary Outcome Measures

Standard Neuropathic Pain Rating Scale
Assessment for improvement, worsening or development of neuropathic pain with an age appropriate standard pain rating scale will be performed pre-procedure, and post-procedure days 1 - 14, and again 30 days, 180 days, 1 year, and 2 year post-procedure.

Full Information

First Posted
April 1, 2011
Last Updated
September 9, 2021
Sponsor
James E.Baumgartner, MD
Collaborators
The Institute for Rehabilitaion and Research Foundation, The University of Texas Health Science Center, Houston, M.D. Anderson Cancer Center, Baylor College of Medicine, Florida Hospital for Children
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1. Study Identification

Unique Protocol Identification Number
NCT01328860
Brief Title
Autologous Stem Cells for Spinal Cord Injury (SCI) in Children
Official Title
Safety of Autologous Stem Cell Treatment for Spinal Cord Injury in Children
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Terminated
Why Stopped
Principal Investigator relocated to Orlando, Florida.
Study Start Date
April 2011 (undefined)
Primary Completion Date
June 2014 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
James E.Baumgartner, MD
Collaborators
The Institute for Rehabilitaion and Research Foundation, The University of Texas Health Science Center, Houston, M.D. Anderson Cancer Center, Baylor College of Medicine, Florida Hospital for Children

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this research study is: To see if Bone Marrow Cell harvest and transplantation are safe in children with Spinal Cord Injury, and To determine if late functional outcome is improved following Bone Marrow Cell transplantation in children with Spinal Cord Injury, using pre-transplantation spinal cord function as the control.
Detailed Description
Of the estimated 11,000 cases of acute spinal cord injury (SCI) which occur each year in North America, 5% involve children. The injury is divided into the primary mechanical event which causes the injury, and the secondary events which follow. Outcome for SCI depends of the severity of the primary injury (complete vs. incomplete) and the spinal cord level of the injury. Current therapy is designed only to minimize the secondary events of SCI and other trauma-associated injuries. Because the current therapy does nothing to reverse the primary insult, significant advances in reducing the disability associated with SCI are unlikely. Recent basic science and animal studies suggest that stem cell treatment can foster functional improvement after SCI by helping repair the primary injury and reducing the secondary injury. Stem cells are "unspecialized" cells in the body that do not have a specific function yet (for example, they have not become "heart cells" or "brain cells" yet.) Stem cells are able to divide and develop into more mature, function-specific cells and take the place of those cells that die, are injured or can no longer function the way they are supposed to. Stem cells are being studied a lot because of this ability and there is the possibility that they may be used to take the place of cells that are no longer working in different parts of the body because of disease (as in cancer, diabetes, and heart disease). Stem cells can be found throughout the body, but they are most common in the bone marrow, the thick, spongy material inside the bones. The primary objective of this study is to determine the safety of transplantation of the patient's own (autologous) Bone Marrow Progenitor Cells (BMPC) in children with SCI. The secondary objective is to determine if functional, physiological and anatomic outcome measures are improved after BMPC autologous transplantation in children with SCI.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinal Cord Injury
Keywords
Autologous, Stem Cells, Spinal Cord Injury, Children

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Biologic; Stem Cells
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
bone marrow progenitor cells (BMPC) autologous transplantation
Other Intervention Name(s)
Autologous Stem Cells, Patient's own Stem Cells
Intervention Description
Not more than 5ml/kg bone marrow will be collected under anesthesia; after the bone marrow has been processed, about 6-8 hours after bone marrow aspiration, subjects will receive the cells via intra-venous (in the vein) infusion and will be monitored for 24 hours for any adverse events.
Primary Outcome Measure Information:
Title
American Spinal Injury Association (ASIA) - Standard Neurological Classification of Spinal Cord Injury.
Description
ASIA classification assessment will take place pre-procedure, 1 day, 30 days, and 180 days post-procedure to define changes in functional outcome.
Time Frame
180 days
Secondary Outcome Measure Information:
Title
Standard Neuropathic Pain Rating Scale
Description
Assessment for improvement, worsening or development of neuropathic pain with an age appropriate standard pain rating scale will be performed pre-procedure, and post-procedure days 1 - 14, and again 30 days, 180 days, 1 year, and 2 year post-procedure.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
15 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Between 1 year and 15 years of age on the day of study BMPC infusion. Survived at least six months with PSCI, but are less than 4 years post injury (± 30 days), and have fixed neurologic deficits related to their injury at the time of enrollment. Ability of child to understand and speak English. Ability of child and caregiver to travel to Houston, Texas, and stay for at least 4 days, and to return for all Follow-up visits (patient is responsible for cost of travel and lodging while in Houston). Pediatric patients with any type of spinal cord injury as long as their spinal cords are continuous on MRI evaluation. This includes paraplegic and quadriplegic patients with complete or incomplete spinal cord injuries. This includes patients with ASIA impairment scales from A to D. The clinical classification will be described by the level below which motor/sensory function is impaired, and the degree of that impairment. (i.e. C-5 if the deltoid muscle is intact but the biceps and other muscle groups below the C-5 level are weak [incomplete motor injury] or paralyzed [complete motor injury]. A similar evaluation of sensory function will be established clinically. Exclusion Criteria: Lack of informed consent. Uncorrected coagulopathy during the baseline period defined as: INR > 1.4; PTT > 35 sec; PLT < 100,000. Pre-injury history of seizure disorder and/or neurological impairment where the patient would not be able to participate in age appropriate pain rating scales. A history of prior SCI or severe traumatic brain injury. Known history of: Recently diagnosed infection (within past 2 weeks) requiring treatment and/or medical intervention. Renal disease or altered renal function as defined by serum creatinine > 1.5 mg/dL. Hepatic disease or altered liver function as defined by SGPT > 150 U/L, and/or T. Bilirubin > 1.3 mg/dL. Malignancy. Immunosuppression as defined by WBC < 3 (10x3) at screening and/or baseline evaluation lab. HIV. Hepatitis B or C. 8. Unhealed fractures or wounds including osteomyelitis. 9. Pneumonia, or chronic lung disease requiring oxygen. 10. An anatomically discontinuous spinal cord diagnosed by CT or MRI imaging. 11. Positive urine pregnancy test (urine pregnancy test will be routinely performed on females of childbearing potential, age 11 or older. 12. Participation in a concurrent intervention study. 13. Desire for organ-donation in the event of death. 14. Unwillingness or inability to stay for at least four days following BMPC infusion (should any problems arise following the infusion) and to return for a 30 day, and 6 month follow-up visit, and be available for 1 year, and 2 year follow-up phone calls.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James E. Baumgartner, MD
Organizational Affiliation
MHHS, Houston,TX & FL Hospital for Children, Orlando, FL
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Rex A. Marco, MD
Organizational Affiliation
University of Texas Health Science Center, Houston TX
Official's Role
Principal Investigator
Facility Information:
Facility Name
Children's Memorial Hemann Hospital; University of Texas Health Science Center - Houston
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

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Autologous Stem Cells for Spinal Cord Injury (SCI) in Children

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