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Stem Cell Infusion in the Treatment of Patients with Neurological Sequelae After Ischemic Stroke

Phase 1
Completed
Conditions
Ischemic Stroke
Interventions
Other: standard stroke treatment and rehabilitation therapy
Biological: UC-MSC infusion via intrathecal route
Biological: UC-MSC infusion via intravenous route
Registration Number
NCT05292625
Lead Sponsor
Vinmec Research Institute of Stem Cell and Gene Technology
Brief Summary

This trial is to investigate the safety and potential therapeutic efficacy of allogeneic administration of umbilical cord-derived MSCs (UC-MSCs) in combination with standard neurological complications after ischemic stroke treatment in Vietnam.

Detailed Description

Stroke is the second leading cause of death behind ischemic heart disease worldwide. Traditional treatments have some limitations whereas preclinical data suggest that stem cell therapy is a promising regenerative medical treatment given the limited capacity of the central nervous system for self-repairs after ischemic stroke. Previous studies have shown that umbilical cord blood-derived Mesenchymal stem cell (UC-MSC) infusion improves the outcomes of several neurological damage conditions, including stroke. These results encouraged us to initiate the phase I/II clinical trial aiming to evaluate the safety and the efficiency of UC-MSC transplantation in the treatment of patients with neurological complications after ischemic stroke. This case-control phase I/II trial is conducted at Vinmec Times City International Hospital, Hanoi, Vietnam between 2021 and 2023. In this trial, 48 patients with neurological complications after ischemic stroke will be enrolled into 3 groups: UC-MSC infusion via intravenous route group (16), UC-MSC infusion via intrathecal administration route group (16), and control group (16). The UC-MSC group (IV/intrathecal) will receive two doses of thawed UC-MSC product at 1.5x106 cells/kg patient body weight with an intervention interval of three months. The primary outcome measures will include the incidence of prespecified administration-associated adverse events (AEs) and serious adverse events (SAEs). The potential efficacy will be measured using these scales including National Institutes of Health Stroke Scale-NIHSS, Functional Independence Measure -FIM, Modified Ashworth Scale-MAS, Fine motor skills-FMS, 36-Item Short Form Survey -SF-36. The clinical evaluation will be conducted at baseline and 3-, 6- and 12-months post-intervention.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
48
Inclusion Criteria

Not provided

Exclusion Criteria
  • Hematologic cause of stroke
  • There is evidence of active infections, failure of heart, lung, liver, or kidney, respiratory distress syndrome, anemia, clotting disorder
  • Cancer.
  • Pregnancy.
  • Tracheostomy, coma, complete quadriplegia, vegetative.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
control armstandard stroke treatment and rehabilitation therapystandard stroke treatment and rehabilitation therapy
UC-MSC infusion via intrathecal routeUC-MSC infusion via intrathecal route1.5 x 10\^6 umbilical Cord Mesenchymal Stem Cells per body kg will be infusion via the intrathecal at baseline, and the second transplantation will be performed 3 months after the first transplantation and combination with standard frailty treatment and supplementary medication
UC-MSC infusion via intravenous routestandard stroke treatment and rehabilitation therapy1.5 x 10\^6 umbilical Cord Mesenchymal Stem Cells per body kg will be infusion via the intravenous at baseline, and the second transplantation will be performed 3 months after the first transplantation and combination with standard frailty treatment and supplementary medication
UC-MSC infusion via intrathecal routestandard stroke treatment and rehabilitation therapy1.5 x 10\^6 umbilical Cord Mesenchymal Stem Cells per body kg will be infusion via the intrathecal at baseline, and the second transplantation will be performed 3 months after the first transplantation and combination with standard frailty treatment and supplementary medication
UC-MSC infusion via intravenous routeUC-MSC infusion via intravenous route1.5 x 10\^6 umbilical Cord Mesenchymal Stem Cells per body kg will be infusion via the intravenous at baseline, and the second transplantation will be performed 3 months after the first transplantation and combination with standard frailty treatment and supplementary medication
Primary Outcome Measures
NameTimeMethod
Adverse events and serious adverse eventsup to the 12-month period following treatment

To assess safety, the number of AEs or SAEs during stem cell administration (72 h) at 3 months, 6 months and 12 months after discharge will be evaluated

Secondary Outcome Measures
NameTimeMethod
Fine motor skills (FMI) scoreup to the 12-month period following treatment

Fine motor skills (FMI) scores range from 0 to 58

Functional Independence Measure (FIM) scoreup to the 12-month period following treatment

Functional Independence Measure (FIM) is a widely accepted functional assessment measure used during inpatient rehabilitation with the possible total score ranging from 18 (lowest) to 126 (highest) level of independence

Short Form 36 items (SF-36) scoreup to the 12-month period following treatment

Short Form 36 items (SF-36) consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability

Modified Ashworth Scaleup to the 12-month period following treatment

The modified Ashworth scale purpose is to grade muscle spasticity. The scale is from 0 (No increase in muscle tone) to 4 (affected part(s) rigid in flexion or extension)

National Institutes of Health Stroke Scale (NIHSS) scoreup to the 12-month period following treatment

National Institutes of Health Stroke Scale (NIHSS) scores range from 0 to 42, with higher scores indicating more severe neurological deficit

Trial Locations

Locations (1)

Vinmec Research Institute of Stem Cell and Gene Technology

🇻🇳

Hanoi, Vietnam

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