BACKGROUND: Autologous hematopoietic stem cell transplantation (HSCT) of gene-modified cells is an alternative to enzyme replacement therapy (ERT) and allogeneic HSCT that has shown clinical benefit for adenosine deaminase-deficient (ADA-deficient) SCID when combined with reduced intensity conditioning (RIC) and ERT cessation. Clinical safety and therapeutic efficacy were evaluated in a phase II study. METHODS: Ten subjects with confirmed ADA-deficient SCID and no available matched sibling or family donor were enrolled between 2009 and 2012 and received transplantation with autologous hematopoietic CD34+ cells that were modified with the human ADA cDNA (MND-ADA) γ-retroviral vector after conditioning with busulfan (90 mg/m2) and ERT cessation. Subjects were followed from 33 to 84 months at the time of data analysis. Safety of the procedure was assessed by recording the number of adverse events. Efficacy was assessed by measuring engraftment of gene-modified hematopoietic stem/progenitor cells, ADA gene expression, and immune reconstitution. RESULTS: With the exception of the oldest subject (15 years old at enrollment), all subjects remained off ERT with normalized peripheral blood mononuclear cell (PBMC) ADA activity, improved lymphocyte numbers, and normal proliferative responses to mitogens. Three of nine subjects were able to discontinue intravenous immunoglobulin replacement therapy. The MND-ADA vector was persistently detected in PBMCs (vector copy number [VCN] = 0.1-2.6) and granulocytes (VCN = 0.01-0.3) through the most recent visits at the time of this writing. No patient has developed a leukoproliferative disorder or other vector-related clinical complication since transplant. CONCLUSION: These results demonstrate clinical therapeutic efficacy from gene therapy for ADA-deficient SCID, with an excellent clinical safety profile. TRIAL REGISTRATION: ClinicalTrials.gov NCT00794508. FUNDING: Food and Drug Administration Office of Orphan Product Development award, RO1 FD003005; NHLBI awards, PO1 HL73104 and Z01 HG000122; UCLA Clinical and Translational Science Institute awards, UL1RR033176 and UL1TR000124.
BACKGROUND: Autologous hematopoietic stem cell transplantation (HSCT) of gene-modified cells is an alternative to enzyme replacement therapy (ERT) and allogeneic HSCT that has shown clinical benefit for adenosine deaminase-deficient (ADA-deficient) SCID when combined with reduced intensity conditioning (RIC) and ERT cessation. Clinical safety and therapeutic efficacy were evaluated in a phase II study. METHODS: Ten subjects with confirmed ADA-deficient SCID and no available matched sibling or family donor were enrolled between 2009 and 2012 and received transplantation with autologous hematopoietic CD34+ cells that were modified with the human ADA cDNA (MND-ADA) γ-retroviral vector after conditioning with busulfan (90 mg/m2) and ERT cessation. Subjects were followed from 33 to 84 months at the time of data analysis. Safety of the procedure was assessed by recording the number of adverse events. Efficacy was assessed by measuring engraftment of gene-modified hematopoietic stem/progenitor cells, ADA gene expression, and immune reconstitution. RESULTS: With the exception of the oldest subject (15 years old at enrollment), all subjects remained off ERT with normalized peripheral blood mononuclear cell (PBMC) ADA activity, improved lymphocyte numbers, and normal proliferative responses to mitogens. Three of nine subjects were able to discontinue intravenous immunoglobulin replacement therapy. The MND-ADA vector was persistently detected in PBMCs (vector copy number [VCN] = 0.1-2.6) and granulocytes (VCN = 0.01-0.3) through the most recent visits at the time of this writing. No patient has developed a leukoproliferative disorder or other vector-related clinical complication since transplant. CONCLUSION: These results demonstrate clinical therapeutic efficacy from gene therapy for ADA-deficient SCID, with an excellent clinical safety profile. TRIAL REGISTRATION: ClinicalTrials.gov NCT00794508. FUNDING: Food and Drug Administration Office of Orphan Product Development award, RO1 FD003005; NHLBI awards, PO1 HL73104 and Z01 HG000122; UCLA Clinical and Translational Science Institute awards, UL1RR033176 and UL1TR000124.
Authors: Belinda Chan; Diane Wara; John Bastian; Michael S Hershfield; John Bohnsack; Colleen G Azen; Robertson Parkman; Kenneth Weinberg; Donald B Kohn Journal: Clin Immunol Date: 2005-08-22 Impact factor: 3.969
Authors: Robert Sokolic; Irina Maric; Chimene Kesserwan; Elizabeth Garabedian; I Celine Hanson; Margaret Dodds; Rebecca Buckley; Andrew C Issekutz; Naynesh Kamani; Kit Shaw; Ben Tan; Pawan Bali; Michael S Hershfield; Donald B Kohn; Alan S Wayne; Fabio Candotti Journal: Blood Date: 2011-07-01 Impact factor: 22.113
Authors: H D Ochs; R H Buckley; R H Kobayashi; A L Kobayashi; R U Sorensen; S D Douglas; B L Hamilton; M S Hershfield Journal: Blood Date: 1992-09-01 Impact factor: 22.113
Authors: R M Blaese; K W Culver; A D Miller; C S Carter; T Fleisher; M Clerici; G Shearer; L Chang; Y Chiang; P Tolstoshev; J J Greenblatt; S A Rosenberg; H Klein; M Berger; C A Mullen; W J Ramsey; L Muul; R A Morgan; W F Anderson Journal: Science Date: 1995-10-20 Impact factor: 47.728
Authors: Jason N Belling; Liv K Heidenreich; Zhenhua Tian; Alexandra M Mendoza; Tzu-Ting Chiou; Yao Gong; Natalie Y Chen; Thomas D Young; Natcha Wattanatorn; Jae Hyeon Park; Leonardo Scarabelli; Naihao Chiang; Jack Takahashi; Stephen G Young; Adam Z Stieg; Satiro De Oliveira; Tony Jun Huang; Paul S Weiss; Steven J Jonas Journal: Proc Natl Acad Sci U S A Date: 2020-05-01 Impact factor: 11.205
Authors: George S Amatuni; Robert J Currier; Joseph A Church; Tracey Bishop; Elena Grimbacher; Alan Anh-Chuong Nguyen; Rajni Agarwal-Hashmi; Constantino P Aznar; Manish J Butte; Morton J Cowan; Morna J Dorsey; Christopher C Dvorak; Neena Kapoor; Donald B Kohn; M Louise Markert; Theodore B Moore; Stanley J Naides; Stanley Sciortino; Lisa Feuchtbaum; Rasoul A Koupaei; Jennifer M Puck Journal: Pediatrics Date: 2019-02 Impact factor: 7.124