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Safety of Autologous Stem Cell Infusion for Children With Acquired Hearing Loss

Primary Purpose

Sensorineural Hearing Loss

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Autologous Stem Cells
Sponsored by
James Baumgartner, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sensorineural Hearing Loss

Eligibility Criteria

6 Weeks - 6 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Evidence of a sensorineural hearing loss

    • Unilateral or bilateral in configuration
    • Symmetrical or asymmetrical configuration
    • Sudden or progressive in presentation
    • Moderate to profound in degree (40-90 Decibels (dB) in at least one ear
  2. Normally shaped cochlea, as determined by MRI
  3. The loss must be considered:

    • Acquired
    • Unknown with a negative genetic test.
  4. Fitted for hearing aids no later than six months post detection of loss.
  5. Enrollment in a parent/child intervention program
  6. Age 6 weeks - 6 years old at time of infusion with less than 18 months of hearing loss at the time of cord blood infusion.
  7. Ability of the child and caregiver to travel to Orlando, and stay for at least 4 days, and to return for all follow-up visits.

Exclusion Criteria

  1. Inability to obtain all pertinent medical records:

    • (pertinent physician notes, speech language pathology notes, laboratory findings, test results and imaging studies-must be sent to the research team at least prior to the subject arriving at the study location for preliminary screening and eligibility assessment, preferably14 days before the scheduled hUBC treatment.)
  2. Known history of:

    • Recently treated infection less than 2 weeks before infusion.
    • Renal disease of altered renal function as defined by serum creatinine > 1.5 mg/dl at admission.
    • 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 < 3,000 at admission
    • Human Immunodeficiency Virus (HIV)
    • Hepatitis B
    • Hepatitis C
    • Evidence of an extensive stroke (> 100ml lesion)
    • Pneumonia, or chronic lung disease requiring oxygen
    • Genetic syndromic sensorineural hearing loss
  3. hUBC sample contamination
  4. Banked cord cells totaling less than 6x106 mononuclear cells/kilogram body weight.
  5. Evidence of the following maternal infections during the pregnancy (Hepatitis A, Hepatitis B, Hepatitis C, HIV 1, HIV 2, Human T-lymphotropic Virus (HTLV) 1, HTLV 2 (CMV and Syphilis can be included in the study)
  6. participation in a concurrent intervention study
  7. Unwillingness or inability to stay for 4 days following hUBC infusion (should problems arise following the infusion) and to return for the one month, six month and one year follow-up visits.
  8. Presence of a cochlear implantation device
  9. Evidence of a genetic syndrome
  10. Evidence of conductive hearing loss
  11. Documented recurrent middle ear infections which are frequent (>5 per year)
  12. Otitis media at the time of examination
  13. Sensorineural loss is mild
  14. Over 18 months from identification of hearing loss at time of infusion

Sites / Locations

  • Florida Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Autologous Stem Cells

Arm Description

A single dose of intravenously administered autologous hUCB will be done. The minimum acceptable dose will be 6x10 6th mononuclear cells/kilogram body weight. The hUCB reanimation, cell processing and product infusion will occur at Florida Hospital for Children and the Florida Hospital Center for Cellular Therapy.

Outcomes

Primary Outcome Measures

Safety of Autologous Stem Cell Infusion
To determine if autologous human umbilical cord blood (hUBC) infusion in children with hearing loss is safe and feasible. Infusion related toxicity as measured by: i. hemodynamic instability: An adverse event will be defined as a sustained (> 10 minutes) >20% decrease in MAP. ii. acute lung injury: Chest X-ray will be done at baseline and at 1 day post infusion to assess for polymorphonuclear infiltrates iii. hepatic injury/toxicity: Hepatic panel will be performed at baseline and 1 day post infusion. Injury is defined as acute elevation of the AST/ALT hepatic enzymes > 900 U/dl in the first 24 hours post infusion iv. renal injury/insufficiency: CMP will be performed at baseline and 1 day after infusion v. exacerbation of neurological status: defined as a change in Glasgow Coma Scale, pupillary size/reactivity, motor/sensory evaluation of extremities, and seizure activity from infusion to discharge.

Secondary Outcome Measures

Inner Ear Function, Audition, and Language Development
To determine if autologous hUBC transplantation in children with hearing loss improves inner ear function, audition and language development.

Full Information

First Posted
January 8, 2014
Last Updated
March 1, 2018
Sponsor
James Baumgartner, MD
Collaborators
CBR Systems, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02038972
Brief Title
Safety of Autologous Stem Cell Infusion for Children With Acquired Hearing Loss
Official Title
Safety of Autologous Stem Cell Infusion for Children With Acquired Hearing Loss
Study Type
Interventional

2. Study Status

Record Verification Date
August 2017
Overall Recruitment Status
Completed
Study Start Date
January 2013 (undefined)
Primary Completion Date
December 11, 2015 (Actual)
Study Completion Date
January 10, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
James Baumgartner, MD
Collaborators
CBR Systems, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To determine if autologous human umbilical cord blood infusion in children with acquired hearing loss is safe, feasible, improves inner ear function, audition and language development.
Detailed Description
There is currently no treatment available to repair/reverse acquired sensorineural hearing loss. Recent experiments using human umbilical cord blood treatment of a mouse and guinea pig models have demonstrated hair cell re-growth following acquired sensorineural loss as well as partial restoration of ABR. Autologous human umbilical cord blood therapy, which has been used for over twenty years, has an excellent safety record. This study will determine if autologous human umbilical cord blood infusion in children with hearing loss is safe and feasible, improves inner ear function, audition, and language development. The patients umbilical cord stem cells collected at birth and stored at Cord Blood Registry will be used for infusion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sensorineural Hearing Loss

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Autologous Stem Cells
Arm Type
Experimental
Arm Description
A single dose of intravenously administered autologous hUCB will be done. The minimum acceptable dose will be 6x10 6th mononuclear cells/kilogram body weight. The hUCB reanimation, cell processing and product infusion will occur at Florida Hospital for Children and the Florida Hospital Center for Cellular Therapy.
Intervention Type
Genetic
Intervention Name(s)
Autologous Stem Cells
Other Intervention Name(s)
Cell based therapy
Intervention Description
The subjects autologous stem cells banked at Cord Blood Registry will be infused intravenously by gravity.
Primary Outcome Measure Information:
Title
Safety of Autologous Stem Cell Infusion
Description
To determine if autologous human umbilical cord blood (hUBC) infusion in children with hearing loss is safe and feasible. Infusion related toxicity as measured by: i. hemodynamic instability: An adverse event will be defined as a sustained (> 10 minutes) >20% decrease in MAP. ii. acute lung injury: Chest X-ray will be done at baseline and at 1 day post infusion to assess for polymorphonuclear infiltrates iii. hepatic injury/toxicity: Hepatic panel will be performed at baseline and 1 day post infusion. Injury is defined as acute elevation of the AST/ALT hepatic enzymes > 900 U/dl in the first 24 hours post infusion iv. renal injury/insufficiency: CMP will be performed at baseline and 1 day after infusion v. exacerbation of neurological status: defined as a change in Glasgow Coma Scale, pupillary size/reactivity, motor/sensory evaluation of extremities, and seizure activity from infusion to discharge.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Inner Ear Function, Audition, and Language Development
Description
To determine if autologous hUBC transplantation in children with hearing loss improves inner ear function, audition and language development.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Weeks
Maximum Age & Unit of Time
6 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Evidence of a sensorineural hearing loss Unilateral or bilateral in configuration Symmetrical or asymmetrical configuration Sudden or progressive in presentation Moderate to profound in degree (40-90 Decibels (dB) in at least one ear Normally shaped cochlea, as determined by MRI The loss must be considered: Acquired Unknown with a negative genetic test. Fitted for hearing aids no later than six months post detection of loss. Enrollment in a parent/child intervention program Age 6 weeks - 6 years old at time of infusion with less than 18 months of hearing loss at the time of cord blood infusion. Ability of the child and caregiver to travel to Orlando, and stay for at least 4 days, and to return for all follow-up visits. Exclusion Criteria Inability to obtain all pertinent medical records: (pertinent physician notes, speech language pathology notes, laboratory findings, test results and imaging studies-must be sent to the research team at least prior to the subject arriving at the study location for preliminary screening and eligibility assessment, preferably14 days before the scheduled hUBC treatment.) Known history of: Recently treated infection less than 2 weeks before infusion. Renal disease of altered renal function as defined by serum creatinine > 1.5 mg/dl at admission. 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 < 3,000 at admission Human Immunodeficiency Virus (HIV) Hepatitis B Hepatitis C Evidence of an extensive stroke (> 100ml lesion) Pneumonia, or chronic lung disease requiring oxygen Genetic syndromic sensorineural hearing loss hUBC sample contamination Banked cord cells totaling less than 6x106 mononuclear cells/kilogram body weight. Evidence of the following maternal infections during the pregnancy (Hepatitis A, Hepatitis B, Hepatitis C, HIV 1, HIV 2, Human T-lymphotropic Virus (HTLV) 1, HTLV 2 (CMV and Syphilis can be included in the study) participation in a concurrent intervention study Unwillingness or inability to stay for 4 days following hUBC infusion (should problems arise following the infusion) and to return for the one month, six month and one year follow-up visits. Presence of a cochlear implantation device Evidence of a genetic syndrome Evidence of conductive hearing loss Documented recurrent middle ear infections which are frequent (>5 per year) Otitis media at the time of examination Sensorineural loss is mild Over 18 months from identification of hearing loss at time of infusion
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Baumgartner, MD
Organizational Affiliation
AdventHealth
Official's Role
Principal Investigator
Facility Information:
Facility Name
Florida Hospital
City
Orlando
State/Province
Florida
ZIP/Postal Code
32803
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Safety of Autologous Stem Cell Infusion for Children With Acquired Hearing Loss

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