Stem Cell Therapy to Improve Burn Wound Healing

Study Overview
=================
Brief Summary
-----------------
This study will determine the safety of allogeneic stem cell therapy from healthy donors, for 2nd degree burn wounds of less than 20% Total Body Surface Area (TBSA), at four different dose levels. Clinical evaluation will take place every 1 to 4 weeks intervals until wound closure, and then monthly for 6 months following the last administration of MSCs. Once the safety and dose-response analysis in Phase 1 is completed, an expanded trial will be initiated to better examine the efficacy of MSC therapy in 2nd degree burn wounds. Phase 1 will establish the maximum safe dose that will be used in the Phase II trial.

Official Title
-----------------
A Pilot Safety Study of the Administration of Mesenchymal Stem Cells (MSC) in the Treatment of Burn Wounds

Conditions
-----------------
Skin Burn Degree Second

Intervention / Treatment
-----------------
* Biological: Allogeneic (MSC's) Application to the Burn Wounds


Participation Criteria
=================
Eligibility Criteria
-----------------
- Donors: Eligibility Criteria: No history of malignancy No active coagulopathy and/or hypocoagulable state No history of cardio/pulmonary conditions Negative tests for Hepatitis A, Hepatitis B, Hepatitis C, RPR, HIV 1 / 2, HTLV I/II, Chagas Disease, NAT for HCV, HIV and WNV. Hemoglobin ≥ 13.0 g/dL Platelet count 140,000 to 440,000/ul WBC 3.0 to 11.0 K/ul BNP ≤ 100 pg /mL No anomalies on the CBC and differential suggestive of a hematopoietic disorder Creatinine ≤ 1.5 mg/dL ALT ≤ 112 IU/L AST ≤ 100 IU/L Bilirubin < 1.5 mg/dL No diabetes Systolic blood pressure ≤ 170 Diastolic blood pressure ≤ 90 No history of autoimmune disorders Recipients: Inclusion Criteria: Male or female subjects 18 years of age or older with Superficial, Intermediate or Deep 2nd Degree Burn Wounds Injury within the prior 7 days Subjects must understand and give written informed consent. Subjects must agree to have biopsies performed as per protocol Subjects must be accessible for weekly wound treatment and assessment visits Males and females must agree to use an acceptable method of contraception. Exceptions will be females of non-childbearing age and monogamous males who are partners of females of non-childbearing age. Acceptable methods of birth control include; history of sterilization, birth control pills, depoprogesterone injections, a barrier contraceptive such as a condom with or without spermicide cream or gel, diaphragms or cervical cap with or without spermicide cream or gel, or an intrauterine device (IUD). Maximum wound size limited to: Single wound: ≤ 5% body surface area (BSA) Multiple wounds treated in a defined anatomical region with ≤ 20% cumulative BSA. Diabetic subjects: HbA1c ≤ 8% Exclusion Criteria: Solely 1st degree or solely 3rd degree burns Subjects with superficial 2nd degree burn who are expected to heal within 2 weeks post standard therapy Evidence of active infection at the wound site Evidence of significant wound healing prior to treatment Wound located in the area of fingers, toes, face, or perineum Wound where 75% or more extends across joints Electrical or chemical burns Have any requirement for the use of systemic steroids or immunosuppressive Subjects Allergic to human albumin, streptomycin, or penicillin Be a pregnant female or nursing mother Subjects who are known or found to be HIV positive Current history of alcohol or substance abuse or history of alcohol or substance abuse requiring treatment within the past 12 months Patients with severe medical conditions Malignancy (other than non melanoma skin cancer) not in remission or in remission less than 5 years Life expectancy less than two years Severe cardiopulmonary disease restricting ambulation to the clinical facility WBC <3 or > 10 x10⁹/L, Hgb < 9g/dL, platelets count 100x10⁹/L or less, serum creatinine > 1.5 times the upper normal limit, AST or ALT > 2.5 times the upper normal limit. Subjects with abnormal bilirubin levels. Subjects with abnormal PT/INR laboratory values while not on chronic anticoagulant treatment which can be held for minor surgical procedures Those with a known history of coagulopathy Subjects who are potential recipients of tissue or organ transplantation Subjects with circulating Hepatitis B antigen and/or who are seropositive for Hepatitis C antibody History of poor compliance, unreliability

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Allogeneic (MSC's) Application to the Burn Wounds<br>Allogeneic (MSC's) Application to the Burn Wounds. The 1st group of 5 will be started on the lowest dose. If there are no adverse reactions, the 2nd group of 5 will receive a higher dose. This will be repeated for the 3rd and 4th groups with each receiving a higher dose. Up to 2 administrations of cells per dose level to be given over a period of no more than 8 weeks. Each administration of cells will be no less than ten days apart and no more than 6 weeks apart. | Biological: Allogeneic (MSC's) Application to the Burn Wounds<br>* Allogeneic (MSC's) Application to the Burn Wounds. The first group of 5 will be started on the lowest dose. If there are no adverse reactions, the second group of 5 will receive a higher dose. This will be repeated for the third and fourth groups with each receiving a higher dose Initial dose level will be 2.5 x 10³ Allogeneic MSCs cells/square cm. Second dose level 5 X 10³ Allogeneic MSCs cells/square cm. Third dose level 1 X 10⁴ Allogeneic MSCs cells/square cm. Fourth dose level 2 X 10⁴ Allogeneic MSCs cells/square cm. Up to 2 administrations of cells will be allowed per dose level to be given over a period of no more than 8 weeks. Each administration of cells will be no less than ten days apart and no more than 6 weeks apart.<br>* Other names: Stem Cells Application to the Burn Wounds;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Monitoring for adverse events as Assessed by CTCAE v4.0 following administration of allogeneic MSCs to 2nd degree burn wounds. | The study will consist of a dose escalation phase consisting of four dose levels. Each dose level will compare the safety of administering allogeneic MSCs, with 5 patients per group. | 1.5 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Skin Burn Degree Second, Second degree Burn, Burn wound