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Trialing Cord Blood Infusions to Inhibit Complications in Preterm Infants

Review of “Autologous cord blood cell infusion in preterm neonates safely reduces respiratory support duration and potentially preterm complications” from STEM CELLS Translational Medicine by Stuart P. Atkinson

Preterm birth complications such as damage to the lungs and brain represent the first major direct cause of neonatal death; unfortunately, those surviving can suffer from lifelong disabilities, including respiratory complications, learning disabilities, and visual and hearing problems. Animal studies have provided evidence for treatment with cord blood stem cells as a preventative or curative strategy for preterm‐related complications, and while several clinical trials have proven the safety and feasibility of autologous cord blood infusion in neonates [1-5], we currently lack data in preterm neonates.

In a previous study,  a team of researchers headed by Yang Jie (Guangzhou Medical University, Guangzhou, China) provided evidence for the safety and feasibility of intravenous infusion of autologous cord blood mononuclear cells (ACBMNCs) in preterm infants [6]. The team now reports the findings of their prospective study, which analyzed whether ACBMNCs could reduce preterm complications in a new STEM CELLS Translational Medicine article [7].

Here are all the relevant data from this prospective, non-randomized placebo-controlled study investigating ACBMNCs as a means to prevent preterm associated complications:

  • 31 preterm infants (less than 35 weeks gestational age) received either intravenously administered ACBMNCs or normal saline within eight hours after birth
    • Fifteen preterm infants received the ACBMNC infusion and sixteen infants assigned to the control group, with no significant differences in the baseline characteristics and status of the infants between the groups
  • The authors failed to observe a significant difference when comparing mortality and preterm complication rate before discharge 
    • All infants survived
    • Infants receiving ACBMNC infusions displayed fewer prematurity-related complications than controls, but this did not reach significance
    • However, ACBMNC infusion did associate with a significant decrease in the duration of respiratory support (mechanical ventilation and oxygen therapy)

While the authors provide more evidence for the safety and feasibility of ACBMNC infusion soon after birth in preterm neonates as a possible means to reduce the rate of prematurity-related complications, they also note some limitations to their study. Said limitations, which include small sample size, the lack of a substantial number of immature infants, and the non-randomized, single-blinded nature of the study, can be minimized through further multicenter, randomized, double‐blinded, placebo-controlled trials in more immature neonates in the hope of providing evidence for efficacy.

For more on the potential of cord blood and additional stem cell-based therapeutic approaches in preterm infants, stay tuned to the Stem Cells Portal!

References

  1. Chang YS, Ahn SY, Yoo HS, et al., Mesenchymal Stem Cells for Bronchopulmonary Dysplasia: Phase 1 Dose-Escalation Clinical Trial. The Journal of Pediatrics 2014;164:966-972.e6.
  2. Cotten CM, Murtha AP, Goldberg RN, et al., Feasibility of Autologous Cord Blood Cells for Infants with Hypoxic-Ischemic Encephalopathy. The Journal of Pediatrics 2014;164:973-979.e1.
  3. Ahn SY, Chang YS, Kim JH, et al., Two-Year Follow-Up Outcomes of Premature Infants Enrolled in the Phase I Trial of Mesenchymal Stem Cells Transplantation for Bronchopulmonary Dysplasia. The Journal of Pediatrics 2017;185:49-54.e2.
  4. Kotowski M, Litwinska Z, Klos P, et al., Autologous cord blood transfusion in preterm infants - could its humoral effect be the kez to control prematurity-related complications? A preliminary study. Journal of Physiology and Pharmacology 2017;68:921-927.
  5. Rudnicki J, Kawa MP, Kotowski M, et al., Clinical Evaluation of the Safety and Feasibility of Whole Autologous Cord Blood Transplant as a Source of Stem and Progenitor Cells for Extremely Premature Neonates: Preliminary Report. Experimental and Clinical Transplantation 2015;13:563-572.
  6. Yang J, Ren Z, Zhang C, et al., Safety of Autologous Cord Blood Cells for Preterms: A Descriptive Study. Stem Cells International 2018;2018:5268057-5268057.
  7. Ren Z, Xu F, Zhang X, et al., Autologous cord blood cell infusion in preterm neonates safely reduces respiratory support duration and potentially preterm complications. STEM CELLS Translational Medicine 2020;9:169-176.