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Feasibility of autologous cord blood cells for infants with hypoxic-ischemic encephalopathy.

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Date
2014-05
Authors
Cotten, C Michael
Murtha, Amy P
Goldberg, Ronald N
Grotegut, Chad A
Smith, P Brian
Goldstein, Ricki F
Fisher, Kimberley A
Gustafson, Kathryn E
Waters-Pick, Barbara
Swamy, Geeta K
Rattray, Benjamin
Tan, Siddhartha
Kurtzberg, Joanne
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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 article
Subject
Humans
Hypoxia-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
Permalink
https://hdl.handle.net/10161/24697
Published Version (Please cite this version)
10.1016/j.jpeds.2013.11.036
Publication 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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Scholars@Duke

Cotten

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
Goldberg

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.
Grotegut

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
Gustafson

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. 
Kurtzberg

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
Murtha

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
Swamy

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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