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Gene Therapy in Patients with Transfusion-Dependent ß-Thalassemia.
Thompson, Alexis A; Walters, Mark C; Kwiatkowski, Janet; Rasko, John E J; Ribeil, Jean-Antoine; Hongeng, Suradej; Magrin, Elisa; Schiller, Gary J; Payen, Emmanuel; Semeraro, Michaela; Moshous, Despina; Lefrere, Francois; Puy, Hervé; Bourget, Philippe; Magnani, Alessandra; Caccavelli, Laure; Diana, Jean-Sébastien; Suarez, Felipe; Monpoux, Fabrice; Brousse, Valentine; Poirot, Catherine; Brouzes, Chantal; Meritet, Jean-François; Pondarré, Corinne; Beuzard, Yves; Chrétien, Stany; Lefebvre, Thibaud; Teachey, David T; Anurathapan, Usanarat; Ho, P Joy; von Kalle, Christof; Kletzel, Morris; Vichinsky, Elliott; Soni, Sandeep; Veres, Gabor; Negre, Olivier; Ross, Robert W; Davidson, David; Petrusich, Alexandria; Sandler, Laura; Asmal, Mohammed; Hermine, Olivier; De Montalembert, Mariane; Hacein-Bey-Abina, Salima; Blanche, Stéphane; Leboulch, Philippe; Cavazzana, Marina.
Afiliação
  • Thompson AA; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Walters MC; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Kwiatkowski J; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Rasko JEJ; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Ribeil JA; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Hongeng S; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Magrin E; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Schiller GJ; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Payen E; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Semeraro M; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Moshous D; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Lefrere F; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Puy H; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Bourget P; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Magnani A; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Caccavelli L; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Diana JS; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Suarez F; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Monpoux F; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Brousse V; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Poirot C; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Brouzes C; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Meritet JF; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Pondarré C; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Beuzard Y; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Chrétien S; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Lefebvre T; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Teachey DT; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Anurathapan U; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Ho PJ; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • von Kalle C; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Kletzel M; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Vichinsky E; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Soni S; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Veres G; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Negre O; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Ross RW; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Davidson D; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Petrusich A; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Sandler L; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Asmal M; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Hermine O; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • De Montalembert M; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Hacein-Bey-Abina S; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Blanche S; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Leboulch P; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
  • Cavazzana M; From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto
N Engl J Med ; 378(16): 1479-1493, 2018 04 19.
Article em En | MEDLINE | ID: mdl-29669226
ABSTRACT

BACKGROUND:

Donor availability and transplantation-related risks limit the broad use of allogeneic hematopoietic-cell transplantation in patients with transfusion-dependent ß-thalassemia. After previously establishing that lentiviral transfer of a marked ß-globin (ßA-T87Q) gene could substitute for long-term red-cell transfusions in a patient with ß-thalassemia, we wanted to evaluate the safety and efficacy of such gene therapy in patients with transfusion-dependent ß-thalassemia.

METHODS:

In two phase 1-2 studies, we obtained mobilized autologous CD34+ cells from 22 patients (12 to 35 years of age) with transfusion-dependent ß-thalassemia and transduced the cells ex vivo with LentiGlobin BB305 vector, which encodes adult hemoglobin (HbA) with a T87Q amino acid substitution (HbAT87Q). The cells were then reinfused after the patients had undergone myeloablative busulfan conditioning. We subsequently monitored adverse events, vector integration, and levels of replication-competent lentivirus. Efficacy assessments included levels of total hemoglobin and HbAT87Q, transfusion requirements, and average vector copy number.

RESULTS:

At a median of 26 months (range, 15 to 42) after infusion of the gene-modified cells, all but 1 of the 13 patients who had a non-ß0/ß0 genotype had stopped receiving red-cell transfusions; the levels of HbAT87Q ranged from 3.4 to 10.0 g per deciliter, and the levels of total hemoglobin ranged from 8.2 to 13.7 g per deciliter. Correction of biologic markers of dyserythropoiesis was achieved in evaluated patients with hemoglobin levels near normal ranges. In 9 patients with a ß0/ß0 genotype or two copies of the IVS1-110 mutation, the median annualized transfusion volume was decreased by 73%, and red-cell transfusions were discontinued in 3 patients. Treatment-related adverse events were typical of those associated with autologous stem-cell transplantation. No clonal dominance related to vector integration was observed.

CONCLUSIONS:

Gene therapy with autologous CD34+ cells transduced with the BB305 vector reduced or eliminated the need for long-term red-cell transfusions in 22 patients with severe ß-thalassemia without serious adverse events related to the drug product. (Funded by Bluebird Bio and others; HGB-204 and HGB-205 ClinicalTrials.gov numbers, NCT01745120 and NCT02151526 .).
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia Genética / Talassemia beta / Globinas beta Limite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: N Engl J Med Ano de publicação: 2018 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia Genética / Talassemia beta / Globinas beta Limite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: N Engl J Med Ano de publicação: 2018 Tipo de documento: Article