Autologous umbilical cord blood infusion for the treatment of autism in young children: A within-subjects open label study on safety (assessed via caregiver report) and efficacy

IF 5.3 2区 医学 Q1 BEHAVIORAL SCIENCES
Autism Research Pub Date : 2024-06-29 DOI:10.1002/aur.3187
Chui Mae Wong, Charmain Samantha Tan, Natasha Riard, Yeleswarapu Sita Padmini, Lourdes Mary Daniel, Arun Prasath, Ah. Moy Tan, Thiam Chye Tan, Rehena Sultana, Joyce Ching Mei Lam
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Abstract

This study aimed to document the safety and efficacy of a single infusion of autologous umbilical cord blood (UCB) in 20 autistic children aged 24–72 months. A pre-post treatment within-subjects open label design was used. At T = 0, 6, 12, and 18 months, participants underwent detailed and structured safety evaluations (via caregiver report), Vineland Adaptive Behavior Scale (Vineland-3), Stanford Binet Intelligence Scale (SB-5), Expressive One-Word Picture Vocabulary Test, Brief Observation of Social Communication Change (BOSCC), Pervasive Developmental Disorder-Behavior Inventory, Repetitive Behavior Scale-Revised, Sensory Experience Questionnaire (SEQ-2.1), Child Behavior Checklist, Clinical Global Impression-Severity and Improvement (CGI-I) Scales, and eye-gaze tracking. UCB infusion was conducted at T = 6 months, hence, 0–6 months was the control period, and 6–18 months the follow-up period. Of 20 children recruited, 19 completed the study and 1 was withdrawn due to UCB not meeting quality control criteria for infusion. There were 15 males and 4 females with an overall mean (SD) age of 4.15 (0.62) years. Mean (SD) cell dose administered was 38.16 (9.82) million cells/kg. None suffered serious adverse events although there were mild behavioral side effects and one unit grew coagulase negative staphylococcus from a post-thaw sample. There were no significant differences in Vineland-3, SB-5, BOSCC, and SEQ-2.1 scores at T = 12 and T = 18 months. Twelve participants had T = 18 CGI-I scores of 2–3 (minimally to much improved), seven participants had scores of 4 (no change). Autologous UCB infusion in autistic children is generally safe but not without risks, including that of infection. In this within-subjects study, some children showed global symptom improvements while others showed no change. Stem cell therapies for autism should only be conducted under strict clinical trial conditions with clear risk discussions.

自体脐带血输注治疗幼儿自闭症:关于安全性(通过护理人员报告进行评估)和疗效的受试者内开放标签研究。
本研究旨在记录单次输注自体脐带血(UCB)对 20 名 24-72 个月自闭症儿童的安全性和有效性。研究采用受试者内前-后治疗开放标签设计。在 T = 0、6、12 和 18 个月时,参与者接受了详细的结构化安全评估(通过护理人员报告)、文兰适应行为量表 (Vineland-3)、斯坦福比奈智力测验量表 (SB-5)、单字图画词汇表达能力测试、社会交流变化简要观察 (BOSCC)、广泛性发育障碍行为量表、重复行为量表-修订版、感官体验问卷 (SEQ-2. 1)、儿童行为问卷 (SEQ-2. 1)、自闭症儿童行为问卷 (SEQ-2. 1)。1)、儿童行为核对表、临床整体印象-严重程度和改善程度(CGI-I)量表以及眼动跟踪。UCB 输注在 T = 6 个月时进行,因此 0-6 个月为对照期,6-18 个月为随访期。在招募的 20 名儿童中,19 人完成了研究,1 人因 UCB 不符合输注质量控制标准而退出。其中男性 15 人,女性 4 人,平均(标清)年龄为 4.15(0.62)岁。平均(标清)细胞剂量为 38.16 (9.82) 百万细胞/公斤。虽然出现了轻微的行为副作用,有一个单位在解冻后的样本中长出了凝固酶阴性葡萄球菌,但没有出现严重的不良反应。在 T = 12 个月和 T = 18 个月时,Vineland-3、SB-5、BOSCC 和 SEQ-2.1 评分无明显差异。12名参与者在T = 18时的CGI-I评分为2-3分(略有改善到大有改善),7名参与者的评分为4分(无变化)。自闭症儿童的自体 UCB 输注通常是安全的,但也不是没有风险,包括感染风险。在这项受试者内部研究中,一些儿童的症状得到全面改善,而另一些则没有变化。治疗自闭症的干细胞疗法只能在严格的临床试验条件下进行,并进行明确的风险讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Autism Research
Autism Research 医学-行为科学
CiteScore
8.00
自引率
8.50%
发文量
187
审稿时长
>12 weeks
期刊介绍: AUTISM RESEARCH will cover the developmental disorders known as Pervasive Developmental Disorders (or autism spectrum disorders – ASDs). The Journal focuses on basic genetic, neurobiological and psychological mechanisms and how these influence developmental processes in ASDs.
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