Repeated autologous umbilical cord blood infusions are feasible and had no acute safety issues in young babies with congenital hydrocephalus.
BACKGROUND
Babies with congenital hydrocephalus often experience developmental disabilities due to brain injury associated with prolonged increased pressure on the developing brain parenchyma. Umbilical cord blood (CB) infusion has favorable effects in animal models of brain hypoxia and stroke and is being investigated in clinical trials of brain injury in both children and adults. We sought to establish the safety and feasibility of repeated intravenous infusions of autologous CB in young babies with congenital hydrocephalus.


METHODS
Infants with severe congenital hydrocephalus and an available qualified autologous CB unit traveled to Duke for evaluation and CB infusion. When possible, the CB unit was utilized for multiple infusions. Patient and CB data were obtained at the time of infusion and analyzed retrospectively.


RESULTS
From October 2006 to August 2014, 76 patients with congenital hydrocephalus received 143 autologous CB infusions. Most babies received repeated doses, for a total of two (n = 45), three (n = 18), or four (n = 4) infusions. There were no infusion-related adverse events. As expected, all babies experienced developmental delays.


CONCLUSIONS
Cryopreserved CB products may be effectively manipulated to provide multiple CB doses. Repeated intravenous infusion of autologous CB is safe and feasible in young babies with congenital hydrocephalus.
Robertson Clinical and Translational Cell Therapy Program, Duke University, Durham, North Carolina.
Jessica M
JM
Sun
Department of Neurosurgery, Stanford University, Stanford, California.
Gerald A
GA
Grant
Robertson Clinical and Translational Cell Therapy Program, Duke University, Durham, North Carolina.
Colleen
C
McLaughlin
Robertson Clinical and Translational Cell Therapy Program, Duke University, Durham, North Carolina.
June
J
Allison
Robertson Clinical and Translational Cell Therapy Program, Duke University, Durham, North Carolina.
Anne
A
Fitzgerald
Robertson Clinical and Translational Cell Therapy Program, Duke University, Durham, North Carolina.
Barbara
B
Waters-Pick
Robertson Clinical and Translational Cell Therapy Program, Duke University, Durham, North Carolina.
Joanne
J
Kurtzberg
D000367:Age Factors; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects; D002658:Developmental Disabilities / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009657:North Carolina; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome