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UCB Stem Cells for Autism Spectrum Disorders

Phase 1
Completed
Conditions
Autism Spectrum Disorder
Interventions
Other: umbilical cord blood mononuclear stem cells
Registration Number
NCT04710810
Lead Sponsor
St. Petersburg Bekhterev Research Psychoneurological Institute
Brief Summary

Purpose. The goals of the study are to assess the safety of the intravenous infusion of umbilical cord blood (UCB) cells in patients with autism and to confirm changes in social/ communicative skills and cognitive functioning after four infusions of ABO/Rh-matched UCB stem cells.

Material and methods. The sample comprises 30 patients (27 males, 3 females) aged between 3 and 11 years with ASD under the care of the National Medical Research Center for Psychiatry and Neurology (Saint-Petersburg, Russia). Participants are randomly assigned to either the control group (14 males, 1 female) or the experimental group (13 males, 2 females). The experimental group receives intravenous injections of UCB cells four times with a two-week gap between injections. The control group receives standard therapy.

The dynamic of cognitive functions and social/communicative skills assess with Checklist for autism spectrum disorders (CASD), Autism treatment evaluation checklist (ATEC), subscales of Wechsler Intelligence Scale for Children (WISC) - "Digit Span", "Picture completion", "Block design", "Coding".

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • diagnosed ASD by ICD-10 criteria
Exclusion Criteria
  • acute somatic diseases
  • indication for surgical (neurosurgical) therapy
  • acute or chronic infectious diseases
  • history of acute allergic reactions

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Experimentalumbilical cord blood mononuclear stem cellsPatients receive group and rhesus compatible UCB cells through intravenous bolus injections (4 injections at 2-week intervals) after pre-medication with Clemastine (0.025 mg/kg body weight, intravenously). One dose is 250±10 x 10⁶ viable cells per sample.
Primary Outcome Measures
NameTimeMethod
Incidence of Treatment Emergent Adverse Events24 hours after infusion

Assessed by Adverse Event Grading Scale. It categorized adverse events according to severity.

Mild Adverse Event - event results in mild or transient discomfort, not requiring intervention or treatment; does not limit or interfere with daily activities (e.g., insomnia, mild headache).

Moderate Adverse Event - event is sufficiently discomforting so as to limit or interfere with daily activities; may require interventional treatment (e.g., fever requiring antipyretic medication).

Severe and undesirable Adverse Event - event results in significant symptoms that prevent normal daily activities; may require hospitalization or invasive intervention (e.g., anemia resulting in blood transfusion).

Changes in severity of autistic symptoms from baseline at 3d and 6th month (measured by Checklist for Autism Spectrum Disorders (CASD)at baseline, 3d and 6th month

The CASD rates 30 symptoms of autism, covering six domains: problems with social interaction, perseveration, somatosensory disturbance, atypical communication and development, mood, problems with attention and safety. Symptoms are scored as present or absent based on information drawn from various sources, including teacher, caregiver, parent, observation of the child, and available records. The scores from each subscale are combined in order to calculate a Total Score, which ranges from 0 to 30 points. A lower score indicates less severe symptoms of ASD and a higher score correlates with more severe symptoms of ASD.

Changes in severity of autistic symptoms from baseline at 3d and 6th month (measured by Autism Treatment Evaluation Checklist (ATEC)at baseline, 3d and 6th month

The purpose of the ATEC is to measure a change in a patient due to various interventions. It consists of four subtests: Speech/Language Communication (14 items); Sociability (20 items); Sensory/ Cognitive Awareness (18 items); Health/Physical/Behavior (25 items). The scores from each subscale are combined in order to calculate a Total Score, which ranges from 0 to 179 points. A lower score indicates less severe symptoms of ASD and a higher score correlates with more severe symptoms of ASD.

Secondary Outcome Measures
NameTimeMethod
"Block design" subscale of Wechsler Intelligence Scale for Children (WISC)at baseline, 6th month

It helps to measure spatial analysis, abstract visual problem-solving. It provides blocks and pictures, and the child must put the blocks together to re-create what's in the picture of the blocks. A primary score ranges from 0 to 55 points. The primary score is further converted into a final score in accordance with the age of the patient. A higher score means better cognitive functioning.

"Digit Span" subscale of Wechsler Intelligence Scale for Children (WISC)at baseline, 6th month

It assesses short-term auditory memory, concentration. The child is asked to repeat dictated series of digits forwards and other series backwards. Series begin with two digits and keep increasing in length, with two trials at each length. A primary score ranges from 0 to 9 points for forward series and from 0 to 8 points for backward series. The primary score is further converted into a final score in accordance with the age of the patient. A higher score correlates with better cognitive functioning.

"Coding" subscale of Wechsler Intelligence Scale for Children (WISC)at baseline, 6th month

It assesses visual-motor coordination, speed, concentration. Coding A is used for children under age 8. The child is asked to mark rows of shapes with different lines according to a code as quickly as possible for 2 minutes. A primary score ranges (Coding A) from 0 to 50 points. Coding B is used for children aged 8 and older. The child is asked to transcribe a digit-symbol code as quickly as possible for two minutes. A primary score ranges (Coding B) from 0 to 93 points. The primary score is further converted into the final score in accordance with the age of the patient. A higher score means better cognitive functioning.

"Picture completion" subscale of Wechsler Intelligence Scale for Children (WISC)at baseline, 6th month

This subscale measures alertness to detail, visual discrimination. The child is asked to identify missing parts of pictures. A primary score ranges from 0 to 20 points. The primary score is further converted into a final score in accordance with the age of the patient. A higher score means better cognitive functioning.

Trial Locations

Locations (1)

St.-Petersburg Bekhterev Reserach Psychoneurological Institute

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Saint Petersburg, Санкт-Петербург, Russian Federation

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