Strategy for a multicenter phase I clinical trial to evaluate globin gene transfer in beta-thalassemia.
Globin gene transfer in autologous hematopoietic stem cells offers a potentially curative treatment option for patients suffering from beta-thalassemia major who lack an HLA-matched hematopoietic stem cell donor. Based on extensive preclinical investigation, we are initiating a phase I clinical trial using G-CSF mobilized, autologous CD34(+) cells transduced with a vector similar to the original TNS9 vector. Our first mobilizations in adult beta-thalassemic subjects have been well tolerated and yielded the required CD34(+) cell dose. To minimize toxicity to enrolled subjects, and in the absence of a demonstrated requirement for myeloablative conditioning, our trial will use a reduced intensity conditioning regimen. Because low vector titers may adversely affect efficacy and safety, we have focused on vector manufacturing processes. We are now in a position to transfer our globin lentiviral vectors in a clinically relevant dosage (averaging 0.8 vector copy per cell in bulk CD34(+) cells) and to supply clinical grade vector to collaborating centers in the U.S.A. and in Europe. We anticipate that the first U.S. trial of globin gene transfer will start in 2010.
Sadelain
Michel
M
Center for Cell Engineering, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. m-sadelain@ski.mskcc.org
Rivière
Isabelle
I
Wang
Xiuyan
X
Boulad
Farid
F
Prockop
Susan
S
Giardina
Patricia
P
Maggio
Aurelio
A
Galanello
Renzo
R
Locatelli
Franco
F
Yannaki
Evangelia
E
D000328:Adult; D000818:Animals; D017321:Clinical Trials, Phase I as Topic; D018014:Gene Transfer Techniques; D015316:Genetic Therapy; D005822:Genetic Vectors / Q000627:therapeutic use; D006801:Humans; D051379:Mice; D015337:Multicenter Studies as Topic; D019172:Transplantation Conditioning; D017086:beta-Thalassemia / Q000235:genetics* / Q000628:therapy*