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CompletedNCT04290182Updated Jan 27, 2026

A Study of Local Administration of Autologous Mesenchymal Stromal Cells in Dysphonic Patients With Vocal Fold Scarring

A Phase 1/2 interventional study of MSC-KI-PL-204 in Hoarseness, Dysphonia and Aphonia, sponsored by Karolinska University Hospital. Completed at 1 site in Sweden. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-01-27.

Sponsored by Karolinska University Hospital · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
9
Allocation
Not applicable
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The overall aim of the project is to develop a new method for treatment of untreatable severe hoarseness due to vocal fold scarring by local injection of autologous mesenchymal stromal cells (MSC). At present there is no lasting effective treatment for this condition which results in personal suffering, and often extended sick leave, change of work or unemployement for the patients.

Based on the previous results the investigators expect the autologous MSC product KI-MSC-PL-204 to be a new effective treatment without side effects for many patients with severe hoarseness or aphonia due to vocal fold scarring.

Read the detailed description

The general aim of the project is to develop a treatment for severe hoarseness due to vocal fold (VF) scarring. Vocal fold scarring can be caused by tumor surgery, radiotherapy, severe inflammation or is early acquired (sulcus vocalis with scar) and results in stiff vocal folds with decreased vibratory capacity and severe deterioration or total loss of voice (aphonia). There is no lasting effective treatment. Bone marrow derived mesenchymal stem cells (MSC) are immunomodulatory, decrease inflammation and improve endogenous healing. After receiving ethical permission the investigators have since 2012 treated 16 patients with manifest vocal fold scarring and severe hoarseness by scar resection and local injection of autologous bone marrow MSC to restore speech. This project was the first in the world to study the effects of MSC treatment of vocal fold scarring in humans. Analysis was made before and up to 12 months post operatively with voice recordings, examination with high speed camera and elasticity measurements of the vocal folds with novel technology. No side effects were found for any patient and for two thirds of the patients with 12 months follow-up the vocal fold function improved and no patient deteriorated.

While cell therapy with autologous MSC was classified according to the Tissue Legislation before 2015, it is now regarded as drug treatment. In accordance with this legislation, the MSC production is now full scale GMP. The investigators have recently received permissions from Swedish Medical Product Agency (DNr 5.1-2019-92069) and from the Regional ethic committee (Drn 2019-06160) for an open Phase I/Il study in patients with severe dysphonia and vocal fold scarring to evaluate safety, tolerability and vocal function after surgery with local administration of autologous mesenchymal stromal cell product KI-MSC-PL-204 as an extended study on 15 patients.

MSC may in the future be used to treat patients with severe hoarseness due to scarring, as well as other damages in the airways.

02

Conditions studied

  • Hoarseness
  • Dysphonia
  • Aphonia
  • Vocal Fold Scar

Keywords

  • Vocal fold scar
  • MSC
  • dysphonia
03

In context

Hoarseness

52 studies on the registry are indexed under Hoarseness; 9 are open to participants now.

This study's enrollment of 9 is below the median of 108 across 44 interventional studies indexed under Hoarseness.

Browse Hoarseness studies →

Lead sponsor

Karolinska University Hospital is the lead sponsor of 279 studies on the registry; 55 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients between 18-65 years with VF scarring and severe voice problems, such as permanent severe hoarseness, complete aphonia or severe voice strain during speech (>1 year) where other treatments have proven ineffective and no alternative treatment is possible.
  • No alternative treatment ongoing or planned (phonosurgery with augmentation implantation, voice therapy or other medical treatment).

Exclusion criteria

Exclusion Criteria:

  • Active treatment of laryngeal disorder, inflammatory condition of the larynx, or laryngeal/VF papilloma.
  • Diagnosed or suspicion of local or other malignancies, Disease-free period of >5 years after malignant disease (>10 years for local laryngeal cancer).
  • Smokers.
  • Large scar defects.
  • Pregnant or nursing (lactating) women.
  • Serological evidence of infection with , , , HTLV and/or syphilis.
  • Active ongoing local or systemic infections.
  • Ongoing immune suppressive treatment.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
9 participants (actual)

Study arms

  • Experimental
    Single arm: MSC administration to vocal fold scar

    1 single arm: Local injection of autologus MSC product (KI-MSC-PL-204) into scarred vocal fold (0,5-1 million cellls/Vocal fold, maximum 2 million cells if bilateral vocal fold scar)

    Biological: MSC-KI-PL-204

Interventions

  • BiologicalMSC-KI-PL-204

    Autologous MSC product

06

What researchers measure

Primary outcomes

  1. Safety and tolerability of treatment

    Number of serious adverse events/ adverse events treatment and conseques

    Time frame: 3 year

Secondary outcomes

  1. Assessment of VF function by high speed laryngeal/stroboscopy recordings

    Description: Assessment of VF function change from baseline to 1 year after treatment, as evaluated by an expert panel of high speed laryngeal/stroboscopy recordings. (Expert panel catagories: (Improved, unchanged, deteriorated)

    Time frame: from baseline to 1 year after treatment.

  2. Assessment of subjective VHI change (points)

    Assessment of patient´s subjective VHI (voice handicap index) ratings change (points)

    Time frame: changes from baseline to 1 year after treatement

  3. Assessment of Phonation Threshold Pressure changes (cmH2O)

    Measurements of phonation threshold pressure (PTP) changes from baseline to 1 year after treatment

    Time frame: changes from baseline to 1 year after treatment

  4. Assessment of perceptual voice analysis changes (points)

    Evaluation by an expert panel of perceptual voice parameters, changes from baseline to 1 year after treatment

    Time frame: changes from baseline to 1 year after treatment

  5. Assessment of subjective VFI change (points)

    Assessment of Vocal fatigue index (VFI) changes from baseline to 1 year after treatment

    Time frame: from baseline to 1 year after treatment

  6. Assessment of maximum phonation time change (seconds)

    Measurements of maximum phonation time change from baseline to 1 year after treatment

    Time frame: from baseline to 1 year after treatment

07

Study locations

1 site
  • Karolinska Trial Alliance
    Stockholm, Stockholm County 11324, Sweden
08

References and documents

Publications

  • Bergstrom Borlin E, Nygren U, Sodersten M, Granqvist S, Kadri N, Rasmusson Duprez I, Le Blanc K, Hertegard S. An open phase I/IIa study evaluating safety, patient-reported outcomes and voice function after surgery, local administration of mesenchymal stromal cells and voice training in patients with vocal fold scarring and dysphonia. Stem Cell Res Ther. 2026 Apr 19;17(1):146. doi: 10.1186/s13287-026-05022-4. PubMed 42002761 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Mar 2021 to primary completion in Jan 2025, 46 months.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 25, 2020
First posted
Feb 28, 2020
StartActual
Mar 1, 2021
Primary completionActual
Jan 1, 2025
CompletionActual
Jan 1, 2025
Last update
Jan 27, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jan 27, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04290182
Collaborators
Swedish Foundation for Strategic Research
Responsible party
Stellan Hertegård (Adjunct Professor. MD PhD, Karolinska University Hospital) — Principal investigator
First posted
Feb 28, 2020
Start date
Mar 1, 2021
Primary completion
Jan 1, 2025
Completion
Jan 1, 2025
Last update
Jan 27, 2026

Study contacts

Patric Scicluna, Clin Research Manager
study chair · Karolinska Trial Alliance

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2025. You cannot join it, but the record below documents what was studied.

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