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Gene Therapy for X-linked Severe Combined Immunodeficiency (SCID-X1)

Not Applicable
Conditions
X-linked Severe Combined Immunodeficiency
Interventions
Genetic: Single infusion of autologous CD34+ cells transduced with the self-inactivating (SIN) gammaretroviral vector pSRS11.EFS.IL2RG.pre
Registration Number
NCT01175239
Lead Sponsor
Great Ormond Street Hospital for Children NHS Foundation Trust
Brief Summary

X-linked severe combined immunodeficiency (SCID-X1) is an inherited disorder that results in failure of development of the immune system in boys. This trial aims to treat SCID-X1 patients using gene therapy to replace the defective gene.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
Male
Target Recruitment
1
Inclusion Criteria
  1. No HLA identical (A,B,C,DR,DQ) family donor and no HLA identical unrelated donor available within 3 months of diagnosis or patients whose underlying clinical problems and prognosis would be significantly compromised by chemotherapy conditioning (including persisting pneumonitis, protracted diarrhoea requiring parental nutrition, ongoing visceral viral infection (herpes viruses, HSV,VZV,CMV, EBV or adenovirus), systemic BCG infection, virus-induced lymphoproliferation.
  2. Diagnosis of classical SCID-X1 based on immunophenotype (absent, or reduced numbers of non-functional T lymphocytes) and confirmed by DNA sequencing
  3. Parental/guardian voluntary consent
  4. Boys between the ages of 0 and 16
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Single infusion of autologous CD34+ cellsSingle infusion of autologous CD34+ cells transduced with the self-inactivating (SIN) gammaretroviral vector pSRS11.EFS.IL2RG.pre-
Primary Outcome Measures
NameTimeMethod
Immunological reconstitution1-18 months post-infusion,then annually

* Immunophenotyping: detection of naïve CD3+ T-cell numbers, CD4, CD8, TCRαβ, TCRγδ, CD16+CD56+ NK \& gamma chain expression. TRECs may be enumerated as surrogate marker for new thymic emigrants post-gene therapy

* Lymphocyte proliferation assays to test function of T cells

* Representation of TCR families by flow cytometry (Vβ phenotyping), \& CDR3 PCR spectratyping (Vβ spectratyping) to monitor physiological \& potentially pathological clonal expansions

* Restoration of antibody production (IgA, IgM, IgG) \& serological responses to vaccinations \& natural infections.

Secondary Outcome Measures
NameTimeMethod
Incidence of adverse reactionsfrom consent until 5 years post-infusion of gene-modified cells

At each scheduled visit, adverse events that might have occurred since the previous visit or assessment will be elicited from the patient/parent/guardian.

The investigators will maintain a record of all adverse events/occurrences in patients participating in the clinical trial. This record will be noted in the patient's medical notes.

Adverse events that have a causal relationship to the IMP (ARs) and SAEs will be recorded on the AE reporting section of the CRF.

Molecular characterisation of gene transferuntil 5 years post-infusion of gene-modified cells

Quantification of transgene copy numbers is determined on sorted cell populations by real-time PCR methodology. Detailed integration analysis may be used to investigate specific clonal expansions.

Normalisation of nutritional status, growth, and developmentuntil 5 years post-infusion of gene-modified cells

Normalisation of nutritional status, growth, and development will be assessed at each follow-up visit by the investigator through clinical examinations.

Trial Locations

Locations (1)

Great Ormond Street Hospital for Children NHS Trust

🇬🇧

London, United Kingdom

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