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Detection of Residual Donor Erythroid Progenitor Cells after Hematopoietic Stem Cell Transplantation for Patients with Hemoglobinopathies
Published on: September 6, 2017
Gene Therapy for β-Hemoglobinopathies
Marina Cavazzana1, Chiara Antoniani2, Annarita Miccio2
1Biotherapy Department, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France; Biotherapy Clinical Investigation Center, Assistance Publique-Hôpitaux de Paris, INSERM, Groupe Hospitalier Universitaire Ouest, 75015 Paris, France; INSERM UMR 1163, Laboratory of Human Lymphohematopoiesis, 75015 Paris, France; Paris Descartes, Sorbonne Paris Cité University, Imagine Institute, 75015 Paris, France.
Insights
Gene therapy offers a promising alternative to hematopoietic stem cell transplantation for treating inherited blood disorders like beta-thalassemia and sickle cell disease, especially for patients lacking suitable donors.
Area of Science:
- Hematology
- Genetics
- Translational Medicine
Background:
- Beta-thalassemia and sickle cell disease are global hemoglobinopathies.
- Allogeneic hematopoietic stem cell transplantation is the only definitive treatment.
- Gene therapy is emerging as a viable alternative treatment.
Purpose of the Study:
- To summarize clinical translation steps for gene therapy in hemoglobinopathies.
- To discuss novel lentiviral and genome editing strategies.
- To highlight gene therapy's potential for patients lacking HLA-identical donors.
Main Methods:
- Review of current translational medicine efforts.
- Discussion of lentiviral vector-based gene therapy.
- Exploration of genome editing techniques.
Main Results:
- Gene therapy is advancing towards clinical application for hemoglobinopathies.
- Lentiviral and genome editing strategies show significant potential.
- These advancements address limitations of current stem cell transplantations.
Conclusions:
- Gene therapy is a promising treatment for beta-hemoglobinopathies.
- It offers solutions for patients without HLA-identical donors.
- Ongoing research in lentiviral and genome editing is crucial.
Abstract:
β-Thalassemia and sickle cell disease (SCD) are the world's two most widely disseminated hereditary hemoglobinopathies. β-Thalassemia originated in the Mediterranean, Middle Eastern, and Asian regions, and SCD originated in central Africa. However, subsequent population migration means that these two diseases are now global and thus constitute a growing health problem in many countries. Despite remarkable improvements in medical care for patients with β-hemoglobinopathies, there is still only one definitive treatment option: allogeneic hematopoietic stem cell (HSC) transplantation. The development of gene therapy for β-hemoglobinopathies has been justified by (1) the limited availability of human leukocyte antigen (HLA)-identical donors, (2) the narrow window of application of HSC transplantation to the youngest patients, and (3) recent advances in HSC-based gene therapy. The huge ongoing efforts in translational medicine and the high number of related publications show that gene therapy has the potential to become the treatment of choice for patients who lack either an HLA genoidentical sibling or an alternative, medically acceptable donor. In this dynamic scientific context, we first summarize the main steps toward clinical translation of this therapeutic approach and then discuss novel lentiviral- and genome editing-based treatment strategies for β-hemoglobinopathies.
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