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Autologous Mesenchymal Stem Cells Transplantation in Cervical Chronic and Complete Spinal Cord Injury

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ClinicalTrials.gov Identifier: NCT02574572
Recruitment Status : Recruiting
First Posted : October 14, 2015
Last Update Posted : November 28, 2017
Sponsor:
Information provided by (Responsible Party):
Ricardo Ribeiro dos Santos, Hospital Sao Rafael

April 10, 2015
October 14, 2015
November 28, 2017
September 6, 2017
December 31, 2019   (Final data collection date for primary outcome measure)
Number of participants with treatment-related adverse events as assessed by magnetic resonance imaging [ Time Frame: 12 months ]
Same as current
Complete list of historical versions of study NCT02574572 on ClinicalTrials.gov Archive Site
  • Functional improvement in ASIA (American Spinal Injury Association) grade [ Time Frame: 12 months ]
    The investigators will evaluate the conversion rate from ASIA A to B or C in 12 months.
  • Functional improvement regarding the AIS (ASIA Impairment Scale) scores (light touch, pin prik and motor force) [ Time Frame: 12 months ]
    AIS (ASIA Improvement Scale) degree on the ASIA score will be assessed in order to evaluate sensitivity and motor force in 12 months.
  • Improvements in sensorial mapping and neuropathic pain [ Time Frame: 12 months ]
    The patients will be submitted to specific questionnaires and clinical examinations in order to evaluate improvements in sensorial mapping and neuropathic pain.
Same as current
Not Provided
Not Provided
 
Autologous Mesenchymal Stem Cells Transplantation in Cervical Chronic and Complete Spinal Cord Injury
Evaluation of the Safety and Potential Effectiveness of Autologous Mesenchymal Stem Cells Transplantation in Subjects With Cervical Chronic and Complete Spinal Cord Injury
The purpose of this study is to analyze the safety and efficacy of autologous bone marrow mesenchymal stem cell transplantation in patients with cervical chronic and complete spinal cord injury.

This is a pilot, phase I study, in a prospective cohort. The study population will consist of 10 patients who had spinal cord injury for at least 12 months, with cervical chronic and complete spinal cord injury, ASIA grade A.

A practitioner, a surgeon and a nurse will review the medical records of the patients to determine the presence / absence of inclusion / exclusion criteria. If the patient is a potential candidate for the study, an interview will be scheduled to review and confirm his/her eligibility.

Patients will undergo a series of clinical and neurological assessments and will also be submitted to the following procedures:

  • Cell blood count;
  • Biochemical analysis (measurement of electrolytes - sodium, potassium, magnesium);
  • Renal function tests (urea and creatinine);
  • Liver function tests;
  • Coagulation profile;
  • Metabolic profile (glucose, total cholesterol and fractions);
  • Urine summary and culture;
  • Serology required for blood transfusion and marrow transplant in Brazil;
  • Electrocardiogram;
  • Chest X-Ray;
  • Bone densitometry;
  • Urodynamic studies;
  • Somatosensory evoked potential;
  • Computed tomography of thoracic and lumbar spine;
  • Magnetic resonance imaging of the thoracic and lumbar spine.

Also as part of the preoperative evaluation, the patients will respond to questions from the SF (Short Form) -36 questionnaire (for assessment of quality of life) and the questionnaires for the assessment of neuropathic pain.

Clinical follow-up will be kept for patients who suspend their participation in the study for any adverse event and / or laboratory abnormality, or for the patient's own desire, following insurance protocols. In addition to the clinical and surgical follow-up, specific medical care will be offered to patients who experience adverse events, until stabilization of the patient, even if the target date for completion of the study has been exceeded.

The candidates included in the study will be asked to voluntarily participate and give their informed written consent.

Interventional
Phase 1
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Spinal Cord Injury
Biological: Autologous mesenchymal cells transplantation
All patients will undergo laminectomy and autologous mesenchymal cells injection into the lesion area.
Experimental: Single group
Patients with spinal cord injury that will undergo laminectomy and autologous mesenchymal cells intralesional injection
Intervention: Biological: Autologous mesenchymal cells transplantation
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
10
Same as current
June 30, 2020
December 31, 2019   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Blunt spinal cord injury at cervical level, between C5 and C7, or penetrating spinal cord injury, at the same level, provided that the mechanism of injury had been spinal shock, ischemia or hematoma, with at least 12 months of injury;
  • ASIA grade A;
  • Signing of the written consent.

Exclusion Criteria:

  • Spinal cord injuries by sharp objects, firearms, and not traumatic or congenital causes, even if at different levels of the spinal cord;
  • Concomitant brain injuries;
  • Diabetes mellitus type 1 or 2 as defined by fasting glucose above 126 mg / use of medication and medical history;
  • Infectious processes in acute and / or chronic course, confirmed by additional tests and / or medical history;
  • Immunodeficiency, autoimmune diseases and neoplastic processes, confirmed by additional tests and / or medical history;
  • Terminal, neurodegenerative, primary hematologic and musculoskeletal diseases confirmed by additional tests and / or past medical history;
  • Osteopathies reflecting increased risk for bone marrow puncture;
  • Coagulopathies;
  • Severe organ failure (heart, kidney or liver), confirmed by additional tests or medical history;
  • Pregnancy or lactation;
  • Clinical complications that hinder or contraindicate the surgical procedure;
  • Use of metallic implants near vascular structures (such as cardiac pacemaker), or other contraindication to magnetic resonance imaging;
  • Psychiatric disorders, psychosocial and cognitive impairment confirmed by medical evaluation;
  • Abusive use of alcohol and / or illegal substances use;
  • Participation in other clinical trial.
Sexes Eligible for Study: All
18 Years to 65 Years   (Adult)
No
Contact: Ricardo Ribeiro-dos-Santos, PhD 557132816489 ricardoribeiro@cbtc-hsr.org
Brazil
 
 
NCT02574572
SCI-003
Yes
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Not Provided
Ricardo Ribeiro dos Santos, Hospital Sao Rafael
Hospital Sao Rafael
Not Provided
Principal Investigator: Ricardo Ribeiro-dos-Santos, PhD Hospital São Rafael
Study Director: Milena BP Soares, PhD Hospital São Rafael
Study Chair: Bruno SF de Souza, MD, Msc Hospital São Rafael
Study Chair: Ticiana F Larocca, MD, Msc Hospital São Rafael
Study Chair: Rodrigo L Alves, MD, PhD Hospital São Rafael
Study Chair: Carolina T Macedo, MD, MSc Hospital São Rafael
Study Chair: André C Matos, MD Hospital São Rafael
Study Chair: Cristiane F Villarreal, PhD Fundação Oswaldo Cruz
Study Chair: Antônio Olímpio S Moura, MD Hospital São Rafael
Study Chair: Eduardo Brazão, MD Hospital São Rafael
Study Chair: Kátia N Silva, MSc Hospital São Rafael
Study Chair: Daniela N Silva, MSc Hospital São Rafael
Study Chair: Clarissa LM de Souza, MD Hospital São Rafael
Hospital Sao Rafael
November 2017

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP