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Phase 2 N=46 Treatment

Autologous CD34+ Hematopoietic Stem Cells Transduced ex Vivo With Elongation Factor 1 Alpha Shortened (EFS) Lentiviral Vector Encoding for the Human ADA Gene

ADA-SCID

Enrolled (actual)
46
Serious AEs
45.0%
Results posted
Sep 2021
Primary outcome: Primary: Overall Survival (OS) of Subjects Treated With Investigational Medicinal Product (IMP) (1 Year) — 100; 85.71; 100; 92.31 percentage of participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Infusion of autologous EFS-ADA LV CD34+ (OTL-101) (Genetic); busulfan (Drug); PEG-ADA ERT (Drug)
Age
Pediatric · 0+ yrs
Sex
All
Sponsor
University of California, Los Angeles
Primary completion
Aug 2018

Outcome Measures

OutcomeResultp-value
PRIMARY
Overall Survival (OS) of Subjects Treated With Investigational Medicinal Product (IMP) (1 Year)
100; 85.71; 100; 92.31
PRIMARY
Event-free Survival (EvFS) of Subjects Treated With Investigational Medicinal Product (IMP) (1 Year)
100; 64.29; 100; 80.77
SECONDARY
OS of Subjects Treated With Investigational Medicinal Product (IMP) (2 Years)
100; 85.71; 90.91; 88.00
SECONDARY
EvFS of Subjects Treated With Investigational Medicinal Product (IMP) (2 Years)
100; 50.00; 63.64; 56.00
SECONDARY
Vector Copy Number (VCN) in Peripheral Blood (PB) Granulocytes.
0.093
SECONDARY
VCN in Peripheral Blood Mononuclear Cells (PBMCs)
0.972
SECONDARY
ADA Activity in Erythrocytes
105.50; 48.500; 1.000; 2.000
SECONDARY
Reduction in Deoxyadenosine Nucleotide (dAXP) in Erythrocytes
0.0330; 0.0360; 0.0360
SECONDARY
Change From Baseline in CD3+ T Cell Counts (2 Years)
569.0; 340.0; 538.0; 395.5
SECONDARY
Number of Single Integration Sites Representing >30% of the Total Integration Sites (2 Years)
SECONDARY
Severe Infection Rate Excluding the First Three Months After Treatment
0.20; 0.56; 0.15; 0.36

Summary

The aim of this study is to assess the safety and efficacy of autologous transplantation of hematopoietic stem cells (CD34+ cells) from the bone marrow (BM) of ADA-deficient SCID infants and children following human ADA cDNA transfer by the EFS-ADA lentiviral vector. The level of gene transfer in blood cells and immune function will be measured as endpoints.

Eligibility Criteria

Inclusion Criteria

-Children ≥ 1.0 months of age with a diagnosis of ADA-deficient SCID based on A. Decreased ADA enzymatic activity in erythrocytes, leukocytes, skin fibroblasts, or in cultured fetal cells to levels consistent with ADA-deficient SCID as determined by reference laboratory or confirmed ADA gene mutation(s) known to cause disease , AND

B. Evidence of severe combined immunodeficiency based on either:

  • Family history of first order relative with ADA deficiency and clinical and laboratory evidence of severe immunologic deficiency, OR
  • Evidence of severe immunologic deficiency in subject prior to institution of immune restorative therapy, based on
  • lymphopenia (absolute lymphocyte count 2 years of age).
  • Neutropenia (absolute granulocyte count 2 times the upper limits of normal or Partial Thromboplastin Time (PTT) > 2.33 times the upper limit of normal (patients with a correctable deficiency controlled on medication will not be excluded).
  • Cytogenetic abnormalities on peripheral blood or bone marrow or amniotic fluid (if available).
  • Prior allogeneic Hematopoietic Stem Cell Transplant (HSCT) with cytoreductive conditioning
  • Infectious

a. Evidence of infection with HIV-1, hepatitis B, Hepatitis C, or parvovirus B 19 by DNA Polymerase Chain Reaction (PCR) within 90 days prior to bone marrow harvest. If other infection is present, it must be under control (e.g. stable or decreasing viral load) at the time of screening

  • Pulmonary
  • Resting O2 saturation by pulse oximetry = 1.2 mg/dl, or >= 3+ proteinuria.
  • Abnormal serum sodium, potassium, calcium, magnesium, phosphate at grade III or IV by Division of AIDS Toxicity Scale.
  • Hepatic/GI:
  • Serum transaminases > 5 times the upper limit of normal (ULN).
  • Serum bilirubin > 2 times ULN.
  • Serum glucose > 1.5 times ULN.
  • Intractable severe diarrhea.
  • Oncologic
  • Evidence of active malignant disease other than dermatofibrosarcoma protuberans (DFSP)
  • Evidence of DFSP expected to require anti-neoplastic therapy within the 5 years following the infusion of genetically corrected cells
  • Evidence of DFSP expected to be life limiting within the 5 years following the infusion of genetically corrected cells
  • Known sensitivity to Busulfan
  • General
  • Expected survival < 6 months.
  • Pregnant.
  • Major congenital anomaly.
  • Ineligible for autologous HSCT by the criteria at the clinical site.
  • Other conditions which in the opinion of the principal investigator and/or co-investigators, contra-indicate the bone marrow harvest, the administration of busulfan, infusion of transduced cells or indicate the patient or patient's parents/primary caregivers inability to follow protocol.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01852071). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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