ADA Gene Transfer Into Hematopoietic Stem/Progenitor Cells for the Treatment of ADA-SCID (Gene-ADA)
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Purpose
This is a phase I/II protocol to evaluate the safety and efficacy of ADA gene transfer into hematopoietic stem/progenitor cells for the treatment of adenosine deaminase (ADA)-deficiency. This condition is an autosomal recessive form of Severe Combined Immunodeficiency (SCID) characterized by impaired immune responses, recurrent infections, failure to thrive and systemic toxicity due to accumulation of purine metabolites. Transplants from an HLA-identical sibling donor is the treatment of choice, but available for a minority of patients. The use of alternative bone marrow donors or enzyme replacement therapy is associated with important drawbacks. The drug product studied in this protocol consists of autologous CD34+ hematopoietic stem/progenitor cells engineered ex vivo with a retroviral vector encoding the therapeutic gene ADA. The engineered CD34+ cells are infused following a nonmyeloablative conditioning with busulfan to make space in the bone marrow. The study objectives are: a) to evaluate the safety and the clinical efficacy of gene therapy, in the absence of enzyme replacement therapy; b) to evaluate the biological activity (engraftment, ADA expression) of ADA transduced CD34+ cells and their hematopoietic progeny. c) to evaluate the immunological reconstitution and purine metabolism after gene therapy.
| Condition | Intervention | Phase |
|---|---|---|
|
Immunologic Deficiency Syndromes |
Genetic: Gene transduced CD34+ cells |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | ADA Gene Transfer Into Hematopoietic Stem/Progenitor Cells for the Treatment of ADA-SCID |
- survival [ Time Frame: minimum of 1 year ] [ Designated as safety issue: No ]
- Change in the rate of severe infection [ Time Frame: During follow up ] [ Designated as safety issue: No ]
- T-lymphocyte counts [ Time Frame: one year ] [ Designated as safety issue: No ]
- Modification of the systemic metabolic defect [ Time Frame: one year ] [ Designated as safety issue: No ]
- presence of genetically modified cells in the BM and PB [ Time Frame: one year ] [ Designated as safety issue: No ]
| Enrollment: | 12 |
| Study Start Date: | October 2002 |
| Study Completion Date: | July 2011 |
| Primary Completion Date: | July 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: CD34+ cells
infusion of autologous CD34+ cells transduced with retroviral vector encoding ADA after non-myeloablative conditioning with Busulphan
|
Genetic: Gene transduced CD34+ cells
infusion of autologous CD34+ cells transduced with retroviral vector encoding ADA after non-myeloablative conditioning with Busulphan
Other Name: Gene therapy
|
Detailed Description:
The safety of the study will be evaluated by description of all adverse events and adverse drug reactions.
The study is aimed at reaching the minimum sample size of ten patients.
Long term follow up all patients enrolled into the study will have a long term follow period from 4 to 8 years after gene therapy
Eligibility| Ages Eligible for Study: | up to 17 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- ADA-SCID with no HLA-identical sibling donor
- pediatric age and at least one of the following criteria:
- inadequate immune response after PEG-ADA for > 6 months
- patients who discontinued PEG-ADA due to intolerance, allergy or auto-immunity
- patients for whom enzyme replacement therapy is not a life long therapeutic option Long term follow-up
- Patients who have received treatment with the Medicinal Product, either as part of the main clinical study, or previous pilot studies or compassionate use program
Exclusion Criteria:
- HIV infection
- history or current malignancy
- Patients who received a previous gene therapy treatment in the 12 months prior to receiving GSK2696273
- any other conditions dangerous for the patients according to the investigator
Contacts and Locations
More Information
No publications provided by GlaxoSmithKline
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | GlaxoSmithKline |
| ClinicalTrials.gov Identifier: | NCT00598481 History of Changes |
| Other Study ID Numbers: | 115611, 15386-PRE21 |
| Study First Received: | January 10, 2008 |
| Last Updated: | March 7, 2013 |
| Health Authority: | Italy: National Institute of Health |
Keywords provided by GlaxoSmithKline:
|
SCID gene therapy Adenosine deaminase retroviral vector |
Additional relevant MeSH terms:
|
Immunologic Deficiency Syndromes Immune System Diseases |
ClinicalTrials.gov processed this record on May 22, 2013