Characteristics of XSCID patients and their autologous retrovirally transduced CD34+ hematopoietic cells
Patient . | P1 . | P2 . | P3 . |
---|---|---|---|
Early history | |||
IL2RG mutation | Poly-A addition site | R289X | M145 frame shift |
Expression of γc protein at cell surface | Trace amount; functional | Normal amount; nonfunctional truncated | None |
Age at first BM transplantation, mo | 6 | 11 | 6 |
No. of prior haploidentical parental BM transplantations | 4 | 2 | 1 |
Adequate T-cell function for more than 2 y after BM transplantation | No | Yes | Yes |
Evaluation prior to gene therapy | |||
Age at gene therapy, y | 11 | 10 | 14 |
Weight and height percentile for age* | <3% | <3% | <3% |
Chronic conditions in addition to recurrent pneumonias and poor growth | Diarrhea, eczema, asthma, alopecia | Diarrhea, sinusitis, asthma, alopecia, malabsorption | Diarrhea, sinusitis, bronchiectasis, warts |
BMT donor chimerism | No donor engraftment | T cells, 49% donor; other lineages, 100% host | T cells, 100% donor; other lineages, 100% host |
CD3+ T cells/μL, nl 650-2108 | 91 | 209 | 1361 |
CD4+ T cells/μL, nl 362-1275 | 84 | 56 | 168 |
CD19+ B cells/μL, nl 49-424 | 263 | 435 | 14 |
CD16/56+ CD3− NK cells/μL, nl 87-505 | 9 | 0 | 3 |
Transduction of CD34+ cells | |||
Initial CD34+ cells/kg placed in culture* | 2.77×107 | 2.33×107 | 1.79×107 |
Total cells/kg harvested, 80%-90% CD34+† | 9.5×107 | 8.0×107 | 7.8×107 |
CD34+ γc-transduced cells/kg, final product‡ | 2.92×107 | 2.85×107 | 3.13×107 |
Retroviral copies/transduced cell, final product§ | 1.1 | 2.3 | 3.7 |
Patient . | P1 . | P2 . | P3 . |
---|---|---|---|
Early history | |||
IL2RG mutation | Poly-A addition site | R289X | M145 frame shift |
Expression of γc protein at cell surface | Trace amount; functional | Normal amount; nonfunctional truncated | None |
Age at first BM transplantation, mo | 6 | 11 | 6 |
No. of prior haploidentical parental BM transplantations | 4 | 2 | 1 |
Adequate T-cell function for more than 2 y after BM transplantation | No | Yes | Yes |
Evaluation prior to gene therapy | |||
Age at gene therapy, y | 11 | 10 | 14 |
Weight and height percentile for age* | <3% | <3% | <3% |
Chronic conditions in addition to recurrent pneumonias and poor growth | Diarrhea, eczema, asthma, alopecia | Diarrhea, sinusitis, asthma, alopecia, malabsorption | Diarrhea, sinusitis, bronchiectasis, warts |
BMT donor chimerism | No donor engraftment | T cells, 49% donor; other lineages, 100% host | T cells, 100% donor; other lineages, 100% host |
CD3+ T cells/μL, nl 650-2108 | 91 | 209 | 1361 |
CD4+ T cells/μL, nl 362-1275 | 84 | 56 | 168 |
CD19+ B cells/μL, nl 49-424 | 263 | 435 | 14 |
CD16/56+ CD3− NK cells/μL, nl 87-505 | 9 | 0 | 3 |
Transduction of CD34+ cells | |||
Initial CD34+ cells/kg placed in culture* | 2.77×107 | 2.33×107 | 1.79×107 |
Total cells/kg harvested, 80%-90% CD34+† | 9.5×107 | 8.0×107 | 7.8×107 |
CD34+ γc-transduced cells/kg, final product‡ | 2.92×107 | 2.85×107 | 3.13×107 |
Retroviral copies/transduced cell, final product§ | 1.1 | 2.3 | 3.7 |
Patients weights at time of treatment: P1, 23 kg; P2, 21.5 kg; P3, 24.5 kg.
Cultured and transduced cells were harvested 96 hours after initiation of culture.
A calculated number based upon total cells infused, where the percent of CD34+ cells was determined on the day of infusion but where the percent of total cells expressing high levels of γc+ transgene was determined by flow cytometry with anti-CD132 fluorescent antibodies on a portion of the infused transduced cells retained in culture for 3 additional days to allow full expression of γc transgene. In the case of P2, whose cells at baseline expressed truncated, nonfunctional γc, transduced cells were clearly identifiable as a population with significantly increased anti-CD132 fluorescence.
A calculated number based on quantitative real-time DNA PCR using virus-specific primers and probes and on measurement of the percentage of cells expressing γc transgene on a portion of the transduced cells retained in culture for 3 additional days to ensure that only integrated vector contributed to the measured copy number.