Feasibility of autologous cord blood cells for infants with hypoxic-ischemic encephalopathy.
Abstract
<h4>Objective</h4>To assess feasibility and safety of providing autologous umbilical
cord blood (UCB) cells to neonates with hypoxic-ischemic encephalopathy (HIE).<h4>Study
design</h4>We enrolled infants in the intensive care nursery who were cooled for HIE
and had available UCB in an open-label study of non-cyropreserved autologous volume-
and red blood cell-reduced UCB cells (up to 4 doses adjusted for volume and red blood
cell content, 1-5 × 10(7) cells/dose). We recorded UCB collection and cell infusion
characteristics, and pre- and post-infusion vital signs. As exploratory analyses,
we compared cell recipients' hospital outcomes (mortality, oral feeds at discharge)
and 1-year survival with Bayley Scales of Infant and Toddler Development, 3rd edition
scores ≥85 in 3 domains (cognitive, language, and motor development) with cooled infants
who did not have available cells.<h4>Results</h4>Twenty-three infants were cooled
and received cells. Median collection and infusion volumes were 36 and 4.3 mL. Vital
signs including oxygen saturation were similar before and after infusions in the first
48 postnatal hours. Cell recipients and concurrent cooled infants had similar hospital
outcomes. Thirteen of 18 (74%) cell recipients and 19 of 46 (41%) concurrent cooled
infants with known 1-year outcomes survived with scores >85.<h4>Conclusions</h4>Collection,
preparation, and infusion of fresh autologous UCB cells for use in infants with HIE
is feasible. A randomized double-blind study is needed.
Type
Journal articleSubject
HumansHypoxia-Ischemia, Brain
Infant, Premature, Diseases
Treatment Outcome
Combined Modality Therapy
Hypothermia, Induced
Cord Blood Stem Cell Transplantation
Transplantation, Autologous
Severity of Illness Index
Follow-Up Studies
Feasibility Studies
Pilot Projects
Developmental Disabilities
Child, Preschool
Infant
Infant, Newborn
Infant, Premature
Female
Male
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https://hdl.handle.net/10161/24697Published Version (Please cite this version)
10.1016/j.jpeds.2013.11.036Publication Info
Cotten, C Michael; Murtha, Amy P; Goldberg, Ronald N; Grotegut, Chad A; Smith, P Brian;
Goldstein, Ricki F; ... Kurtzberg, Joanne (2014). Feasibility of autologous cord blood cells for infants with hypoxic-ischemic encephalopathy.
The Journal of pediatrics, 164(5). pp. 973-979.e1. 10.1016/j.jpeds.2013.11.036. Retrieved from https://hdl.handle.net/10161/24697.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
Charles Michael Cotten
Professor of Pediatrics
I am involved in 4 major areas of research: 1) Neuroprotection. Working with colleagues
from Cell Therapies, we have added to Duke's experience participating in pivotal trials
of hypothermia for term newborns with moderate to severe hypoxic-ischemic encephalopathy
(HIE) by completing a phase I study of autologous cord blood cells for these infants,
and developing and currently leading a multicenter, double-blind randomized clinical
trial of autologous cord blood cells or placebo in te
Ronald Norman Goldberg
Professor Emeritus of Pediatrics
1. Perinatal asphyxia and neuroprotection - use of umbilical cord blood transfusion
2. Persistent Pulmonary hypertension - use of ethyl nitrite 3. The extremely low-birth-weight
infant. 4. Newborn screening - use of digital microfluidics
Ricki Friedman Goldstein
Adjunct Professor in the Department of Pediatrics
My research interests continue to be in the area of medical neurodevelopmental follow-up
of high-risk infants. My past research is involved with studying the long-term outcome
of extremely low birth weight premature infants and full term infants treated with
various types of technology for respiratory failure (extracorporeal membrane oxygenation
(ECMO), and high frequency ventilation). I have been interested in studying clinical
predictors of outcome as well as factors that affect suscept
This author no longer has a Scholars@Duke profile, so the information shown here reflects
their Duke status at the time this item was deposited.
Chad Aaron Grotegut
Associate Professor of Obstetrics and Gynecology
I am a specialist in maternal-fetal medicine, which is a subspecialty of OB/GYN that
focuses on the care of women with high-risk pregnancies. I serve as the Medical Director
of the Labor and Delivery Unit at Duke University Hospital. In that role, and together
with our outstanding unit team members, we have the opportunity to help women and
their families ensure that they have the safest and best labor and delivery experience
possible. My specific clinical int
Kathryn E. Gustafson
Professor in Psychiatry and Behavioral Sciences
My scholarly interests and expertise are in pediatric neurodevelopmental outcomes
assessment and research as well as child and parent coping with chronic childhood
illness. I collaborated with Dr. Robert Thompson on a research program investigating
the transactional biopsychosocial model of adaptation to pediatric conditions in children
and families. Our research program was funded by the NIH and culminated in the publication
of our book, Adaptation to Chronic Childhood Illness.
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
Amy Patricia Murtha
Professor of Obstetrics and Gynecology
Dr. Amy Murtha is a Professor in the Department of Obstetrics and Gynecology and Department
of Pediatrics, and past Vice Chair for Research in Obstetrics and Gynecology. After
graduating from the Medical College of Pennsylvania in 1992 she completed her residency
in OB-GYN and fellowship in Maternal Fetal Medicine (MFM) at Duke University then
joined the faculty at Duke in 1998.
Dr. Murtha served as interim Chair for the Department of OB-GYN and Fellowship Director
for the mater
Geeta Krishna Swamy
Haywood Brown, MD Distinguished Professor of Women's Health
Dr. Geeta Swamy, MD, is Professor of Obstetrics and Gynecology in the Division of
Maternal-Fetal Medicine, having served as the director of the Duke Perinatal Research
Center and Vice Chair for Research and Faculty Development in the Department of ObGyn.
She has achieved international acclaim as a clinician researcher and expert in the
field of maternal immunization and perinatal infection. As a consultant to the World
Health Organization, Dr. Swamy contributes her knowledge to advance inte
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