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A Phase II Randomized Clinical Trial of the Safety and Efficacy of Intravenous Umbilical Cord Blood Infusion for Treatment of Children with Autism Spectrum Disorder.
Abstract
<h4>Objective</h4>To evaluate whether umbilical cord blood (CB) infusion is safe and
associated with improved social and communication abilities in children with autism
spectrum disorder (ASD).<h4>Study design</h4>This prospective, randomized, placebo-controlled,
double-blind study included 180 children with ASD, aged 2-7 years, who received a
single intravenous autologous (n = 56) or allogeneic (n = 63) CB infusion vs placebo
(n = 61) and were evaluated at 6 months postinfusion.<h4>Results</h4>CB infusion was
safe and well tolerated. Analysis of the entire sample showed no evidence that CB
was associated with improvements in the primary outcome, social communication (Vineland
Adaptive Behavior Scales-3 [VABS-3] Socialization Domain), or the secondary outcomes,
autism symptoms (Pervasive Developmental Disorder Behavior Inventory) and vocabulary
(Expressive One-Word Picture Vocabulary Test). There was also no overall evidence
of differential effects by type of CB infused. In a subanalysis of children without
intellectual disability (ID), allogeneic, but not autologous, CB was associated with
improvement in a larger percentage of children on the clinician-rated Clinical Global
Impression-Improvement scale, but the OR for improvement was not significant. Children
without ID treated with CB showed significant improvements in communication skills
(VABS-3 Communication Domain), and exploratory measures including attention to toys
and sustained attention (eye-tracking) and increased alpha and beta electroencephalographic
power.<h4>Conclusions</h4>Overall, a single infusion of CB was not associated with
improved socialization skills or reduced autism symptoms. More research is warranted
to determine whether CB infusion is an effective treatment for some children with
ASD.
Type
Journal articleSubject
Fetal BloodHumans
Treatment Outcome
Blood Transfusion
Follow-Up Studies
Prospective Studies
Double-Blind Method
Communication
Language Tests
Child
Child, Preschool
Female
Male
Autism Spectrum Disorder
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https://hdl.handle.net/10161/24573Published Version (Please cite this version)
10.1016/j.jpeds.2020.03.011Publication Info
Dawson, Geraldine; Sun, Jessica M; Baker, Jennifer; Carpenter, Kimberly; Compton,
Scott; Deaver, Megan; ... Kurtzberg, Joanne (2020). A Phase II Randomized Clinical Trial of the Safety and Efficacy of Intravenous Umbilical
Cord Blood Infusion for Treatment of Children with Autism Spectrum Disorder. The Journal of pediatrics, 222. pp. 164-173.e5. 10.1016/j.jpeds.2020.03.011. Retrieved from https://hdl.handle.net/10161/24573.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Kimberly Carpenter
Assistant Professor in Psychiatry and Behavioral Sciences
Dr. Kimberly Carpenter is a clinical neuroscientist specializing in understanding
complex brain-behavior relationships in young children with autism and associated
disorders. Her program of research includes four interrelated research themes: (1)
Understanding the impact of comorbid disorders on clinical and behavioral outcomes
of young autistic children; (2) Identification of early risk factors for the development
of psychiatric and neurodevelopmental disorders; (3) Identification of brain-b
Scott Nathan Compton
Associate Professor in Psychiatry and Behavioral Sciences
Geraldine Dawson
William Cleland Distinguished Professor
Geraldine Dawson is the William Cleland Distinguished Professor of Psychiatry and
Behavioral Sciences at Duke University, where she also is a Professor of Pediatrics
and Psychology & Neuroscience. Dawson also is the Director of the Duke Center for
Autism and Brain Development, an NIH Autism Center of Excellence, which is an interdisciplinary
research program and clinic, aimed to improve the lives of those diagnosed with autism
through research, education, clinical services, and poli
Lauren Franz
Associate Professor of Psychiatry and Behavioral Sciences
Dr Franz's research focuses on improving access to evidence-based services and support
for neurodevelopmental disabilities, including autism, in diverse, low-resource, local
and global communities.
Nicole Heilbron
Associate Professor in Psychiatry and Behavioral Sciences
Joseph Patrick Horrigan
Associate Consulting Professor in the Department of Psychiatry and Behavioral Sciences
Jill E. Howard
Assistant Professor in Psychiatry and Behavioral Sciences
Autism spectrum disorder diagnosis and treatment, infant-toddler risk and diagnosis,
trajectories of early development
Andrzej Stanislaw Kosinski
Professor of Biostatistics & Bioinformatics
Statistical methodology for evaluation of diagnostic tests Adjustment for misclassification
Missing data Clinical trials Analysis of cardiovascular and stroke data
Joanne Kurtzberg
Jerome S. Harris Distinguished Professor of Pediatrics
Dr. Kurtzberg is an internationally renowned expert in pediatric hematology/oncology,
pediatric blood and marrow transplantation, umbilical cord blood banking and transplantation,
and novel applications of cord blood and birthing tissues in the emerging fields of
cellular therapies and regenerative medicine. Dr. Kurtzberg serves as the Director
of the Marcus Center for Cellular Cures (MC3), Director of the Pediatric Transplant
and Cellular Therapy Program, Director of the Carolina
Kristin Marie Page
Assistant Professor of Pediatrics
Stem cell transplantation and/or cellular therapies can be used to treat a variety
of pediatric diseases including malignancies such as leukemia, lymphoma and myelodysplastic
syndrome in addition to certain non-malignant conditions (such as immune deficiencies,
inherited metabolic diseases, hemoglobinopathies, and bone marrow failure syndromes).
As the Director of the Pediatric Transplant and Cellular Therapy Survivorship Clinic,
my goal is optimize the care of survivors of pediatric stem cell t
Vinod K. Prasad
Consulting Professor in the Department of Pediatrics
1. Expanding the role of umbilical cord blood transplants for inherited metabolic
disorders. 2. Impact of histocompatibility and other determinants of alloreactivity
on clinical outcomes of unrelated cord blood transplants. 3. Studies to analyse the
impact of Killer Immunoglobulin receptors on the outcomes of hematopoietic stem cell
transplantation utilizing haploidentical, CD34 selected, familial grafts. 4. Propective
longitudinal study of serial monitoring of adenovirus in
Allen W Song
Professor in Radiology
The research in our lab is concerned with advancing structural and functional MRI
methodologies (e.g. fast and high-resolution imaging techniques) for human brain imaging.
We also aim to improve our understanding of functional brain signals, including spatiotemporal
characterizations of the blood oxygenation level dependent contrast and alternative
contrast mechanisms that are more directly linked to the neuronal activities. Additional
effort is invested in applying and validating the de
Jessica Muller Sun
Assistant Professor of Pediatrics
Jesse David Troy
Associate Professor of Biostatistics & Bioinformatics
I am a biostatistician supporting research in cancer therapeutics and palliative care
at the Duke Cancer Institute. Prior to this I supported research studies in cell therapies
and regenerative medicine at the Duke Marcus Center for Cellular Cures. I also teach
biostatistics in the Master of Biostatisti
Saritha Vermeer
Assistant Professor in Psychiatry and Behavioral Sciences
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