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A Serious Adverse Event after Successful Gene Therapy for X-Linked Severe Combined Immunodeficiency
Abstract
To the Editor: We recently reported (April 18 issue)1 the sustained correction of X-linked severe combined immunodeficiency disease by ex vivo, retrovirally mediated transfer of the γc gene into CD34+ cells in four of five patients with the disease. These results have since been confirmed in four additional patients with typical X-linked severe combined immunodeficiency. Of the first four successfully treated patients, three continue to do well up to 3.6 years after gene therapy, whereas a serious adverse event occurred in the fourth patient. At a routine checkup 30 months after gene therapy, lymphocytosis consisting of a monoclonal population . . .
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“Lentiviral vectors are considered safer than gamma-retroviral vectors in terms of their semi-random integration patterns, as gene integration does not preferentially occur in start regions of active genes (93-95).”
From Scalable Manufacturing of CAR T Cells for Cancer Immunotherapy (2021) · cites this paper as [93]
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BackgroundIntegrase Defective, Nonintegrating Lentiviral Vectors
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“However, in 2003 the first serious adverse event linked to genetic modification of HSCs or primitive precursor cells with integrating retrovirus vectors was reported.(5,6) This review will summarize the encouraging results of these clinical trials, explain what is known regarding the adverse events linked to genotoxic…”
BackgroundCRISPR medicine for blood disorders: Progress and challenges in delivery
Gol, T. M., Ureña-Bailén, G., Hou, Y., Sinn, R., Antony, J. S., Handgretinger, R., & Mezger, M. (2023) · Frontiers in Genome Editing · doi:10.3389/fgeed.2022.1037290 · Cited by 16
Review of Treatment for Adenosine Deaminase Deficiency (ADA) Severe Combined Immunodeficiency (SCID)
Secord, E., & Hartog, N. (2022) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s350762 · Cited by 13
“ADA deficiency was described in 1972 by Eloise Gilbert when she discovered that the red blood cells (RBC) of two patients with CID contained no ADA enzyme on gel electrophoresis.7 In initial studies looking toward possible treatments the addition of normal red blood cells to cultures of cells from ADA deficient patien…”
BackgroundInfluentialViral gene therapy for paediatric neurological diseases: progress to clinical reality
Privolizzi, R., Chu, W. S., Tijani, M., & Ng, J. (2021) · Developmental Medicine & Child Neurology · doi:10.1111/dmcn.14885 · Cited by 21
“The second was gamma retroviral correction of X-linked severe combined immunodeficiency, which reconstituted immunity but vector-related leukaemia consequently developed.(5) These highlighted an inadequate understanding of vector properties, and gene therapists have worked tirelessly to engineer recombinant viral vect…”
BackgroundEffect of Double Substitution in Cationic Chitosan Derivatives on DNA Transfection Efficiency
Badazhkova, V. D., Raik, S., Polyakov, D., Poshina, D., & Skorik, Y. (2020) · Polymers · doi:10.3390/polym12051057 · Cited by 13
“Viral vectors show high transfection efficiency, but they have some significant shortcomings, including immunogenicity [3,4], insertional mutagenesis [5], and low gene transfer capacity [6,7].”
BackgroundSynthesis of amphoteric curdlan derivatives for delivery of therapeutic nucleic acids.
Tong, Y., Ganbold, T., & Baigude, H. (2017) · Carbohydrate Polymers · doi:10.1016/j.carbpol.2017.08.037 · Cited by 13
Moscatelli, I., Löfvall, H., Thudium, C. S., Rothe, M., Montano, C., Kertész, Z., Sirin, M., Schulz, A., Schambach, A., Henriksen, K., et al. (2017) · Human Gene Therapy · doi:10.1089/hum.2017.053 · Cited by 15
“12 Instead of employing strong viral promoter/enhancer sequences, having led to severe adverse events in past gene therapy trials, 13,14 the use of weaker cellular promoters can increase treatment safety.”
Nordin, F., Ahmad, R. N. R., & Farzaneh, F. (2017) · Virus Research · doi:10.1016/j.virusres.2017.04.007 · Cited by 17
Kerr, A., Tam, L., Hale, A. B., Cioroch, M., Douglas, G., Channon, K., & Wade-Martins, R. (2016) · Molecular Therapy: Nucleic Acids · doi:10.1038/mtna.2016.86 · Cited by 13
Treating hemoglobinopathies using gene-correction approaches: promises and challenges
Cottle, R. N., Lee, C. M., & Bao, G. (2016) · Human Genetics · doi:10.1007/s00439-016-1696-0 · Cited by 17
“The advantage of the nuclease-based approach over conventional gene therapy is the elimination of risks of insertional mutagenesis or viral-induced immune response (Cavazzana-Calvo et al. 2000; Hacein-Bey-Abina et al. 2003b).”
BackgroundNasimuzzaman, M., Lynn, D., Ernst, R., Beuerlein, M., Smith, R. H., Shrestha, A., Cross, S. J., Link, K. A., Lutzko, C., Nordling, D., et al. (2016) · Molecular Therapy: Methods & Clinical Development · doi:10.1038/mtm.2016.4 · Cited by 13
Barbero, N., Magistris, C., Quagliotto, P., Bonandini, L., Barolo, C., Buscaino, R., Compari, C., Contardi, L., Fisicaro, E., & Viscardi, G. (2015) · ChemPlusChem · doi:10.1002/cplu.201500007 · Cited by 13
Giordano, F., Appelt, J., Link, B., Gerdes, S., Lehrer, C.-I., Scholz, S. J., Paruzynski, A., Roeder, I., Wenz, F., Glimm, H., et al. (2015) · Molecular Therapy: Methods & Clinical Development · doi:10.1038/mtm.2014.61 · Cited by 13
Self-citationSchott, J. W., Hoffmann, D., Maetzig, T., Müller, F.-J., Steinemann, D., Zychlinski, D., Cantz, T., Baum, C., & Schambach, A. (2014) · Gene Therapy · doi:10.1038/gt.2014.69 · Cited by 12
McAllister, R. G., Liu, J., Woods, M. W., Tom, S. K., Rupar, C. A., & Barr, S. D. (2014) · Molecular Therapy — Nucleic Acids · doi:10.1038/mtna.2014.39 · Cited by 15
Metadata
- Authors
- Hacein-Bey-Abina, S., von Kalle, C., Schmidt, M., Le Deist, F., Wulffraat, N., McIntyre, E., Radford, I., Villeval, J.-L., Fraser, C. C., Cavazzana-Calvo, M., & Fischer, A.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2003-01-16
- Volume
- 348
- Issue
- 3
- Pages
- 255-256
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2323613689
- Cited by
- 1,867
- References
- 0
- Citations by year
- 2026: 29 · 2025: 32 · 2024: 31 · 2023: 25 · 2022: 47 · 2021: 52 · 2020: 46 · 2019: 50 · 2018: 45 · 2017: 63 · 2016: 65 · 2015: 84 · 2014: 87 · 2013: 92 · 2012: 92
- FWCI
- 86.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Virus-based gene therapy research
- Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
- Health Sciences › Medicine › Oncology › CAR-T cell therapy research
- Keywords
- X-linked severe combined immunodeficiency, gene therapy, adverse events, gene therapy safety
- MeSH terms
- Chromosomes, Human, Pair 11, DNA-Binding Proteins, Humans, Genetic Linkage, Metalloproteins, Proto-Oncogene Proteins, Retroviridae, Genetic Therapy, Gene Expression, Mutagenesis, Insertional, Severe Combined Immunodeficiency, Lymphocyte Count, Chromosomes, Human, X, Adaptor Proteins, Signal Transducing, Precursor Cell Lymphoblastic Leukemia-Lymphoma, LIM Domain Proteins
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