Invasive therapy for children with autism is not justified

Abstract

I am writing about the paper “Outcomes of bone marrow mononuclear cell transplantation combined with interventional education for autism spectrum disorder” by Thanh et al, first published September 9, 2020 in STEM CELLS Translational Medicine. As a pediatrician who cares for autistic children, I have grave concerns about this paper. This paper does not describe valid research but rather details the abuse of disabled children. For one, the authors did not inject stem cells—they injected mononuclear bone marrow cells. They did not report on how many stem cells are in their preparation. Furthermore, injecting anything intrathecally can have serious consequences, including the development of lifelong pain (arachnoiditis) or bleeding into the spinal cord causing paralysis. Such a risky intervention should only be considered if the alternative of no treatment is more dire. Autism is not a dire sentence. There are alternative effective therapies for autism. Subjecting children, without their consent, to a seriously risky procedure is abuse. Forty‐eight percent of the children have side effects, including pain. I do not consider pain a minor adverse event; I consider it major and related to the study. Furthermore, these are disabled children and are a protected vulnerable group in whom research should only be performed if it is of likely/potential benefit and poses minimal risk. In the United States, I doubt this study would be approved by an internal review board.