对于输血依赖β-血病的ExagamglogeneAutotemcel是非常有用的
Franco Locatelli1, Peter Lang1, Donna Wall1
1From IRCCS Ospedale Pediatrico Bambino Gesù (F.L., M.A.) and Catholic University of the Sacred Heart (F.L.), Rome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan (M.D.C.), and the Department of Health Sciences, Magna Graecia University, Catanzaro (M.A.) - all in Italy; University Children's Hospital Tübingen (R.H.), and the Cluster of Excellence iFIT (EXC 2180) "Image-guided and Functionally Instructed Tumor Therapies" and the German Cancer Consortium, Partner Site Tübingen, University of Tübingen (P.L.), Tübingen, the Division of Pediatric Stem Cell Therapy, Department of Pediatric Oncology, Hematology, and Clinical Immunology, Medical Faculty, Heinrich Heine University, Düsseldorf (R.M.), and the University of Regensburg, Regensburg (S.C.) - all in Germany; the Hospital for Sick Children and University of Toronto, Toronto (D.W.), and BC Children's Hospital, University of British Columbia, Vancouver (A.M.L.) - all in Canada; Imperial College Healthcare NHS Trust, St. Mary's Hospital (J.F.), and University College London Hospitals NHS Foundation Trust (B.C.) - both in London; Stanford University, Palo Alto, CA (A.J.S.); Children's Hospital of Philadelphia and Perlman School of Medicine, University of Pennsylvania, Philadelphia (J.L.K., S.G.); Herbert Irving Comprehensive Cancer Center, Columbia University (M.M.), and Joan and Sanford I. Weill Medical College of Cornell University (S.S.) - both in New York; Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (R.I.L.); National and Kapodistrian University of Athens, Athens (A.K.); Vertex Pharmaceuticals, Boston (P.K., D.S., L.R., Y.B., C.S., L.Z., W.E.H.), and CRISPR Therapeutics, Cambridge (P.K.M.) - both in Massachusetts; and Sarah Cannon Research Institute at the Children's Hospital at TriStar Centennial, Nashville (H.F.).
通过exagamglogene autotemcel (exa-cel) 基因治疗,在91%的依赖输血的β-thalassemia患者中实现了输血独立性. 这种CRISPR-Cas9治疗重新激活胎儿血红蛋白,在治疗这种遗传性血液疾病方面取得了重大进展.
科学领域:
- 血液学 血液学 血液学
- 基因治疗 基因治疗
- 遗传学 是一个遗传学.
背景情况:
- 埃克萨-塞尔 (exa-cel) 是一种使用CRISPR-Cas9基因编辑的非病毒细胞疗法.
- 它向自主CD34+造血干细胞和原生细胞 (HSPCs) 中的BCL11A红细胞特异增强器区域.
- 该疗法旨在重新激活胎儿血红蛋白 (HbF) 合成.
研究的目的:
- 为了评估exa-cel在患有输血依赖β-thalassemia的患者中的疗效和安全性.
- 为了评估通过exa-cel治疗实现的输血独立率.
主要方法:
- 进行了一项开放的,单组的,第三阶段的研究.
- 年龄在12-35岁,患有输血依赖性β-thalassemia的患者在用busulfan进行骨髓修复后接受了exa-cel.
- 对HSPCs的CRISPR-Cas9基因编辑进行了ex vivo.
主要成果:
- 91%的患者 (35人中32人有足够的随访) 实现了输血独立.
- 随访时间的中位数为20.4个月.
- 在输血独立期间,平均总血红蛋白为13.1g/dL,平均胎儿血红蛋白为11.9g/dL,具有全细胞分布.
结论:
- 在骨髓剥离之前的exa-cel治疗,导致β-thalassemia患者的输血独立率高.
- 安全性概况与骨髓衰变性busulfan调节和自身的HSPC移植相一致.
- 在研究期间没有报告死亡或癌症.
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