Severe Combined Immunodeficiency (SCID)Leaky SCIDOmenn SyndromeReticular DysgenesisADA SCIDXSCID
Study summary
This study is a prospective evaluation of children with Severe Combined Immune Deficiency (SCID) who are treated under a variety of protocols used by participating institutions. In order to determine the patient, recipient and transplant-related variables that are most important in determining outcome, study investigators will uniformly collect pre-, post- and peri-transplant (or other treatment) information on all children enrolled into this study.
Children will be divided into three strata:
* Stratum A: Typical SCID with virtual absence of autologous T cells and poor T cell function
* Stratum B: Atypical SCID (leaky SCID, Omenn syndrome and reticular dysgenesis with limited T cell diversity or number and reduced function), and
* Stratum C: ADA deficient SCID and XSCID patients receiving alternative therapy including PEG-ADA ERT or gene therapy.
Each Group/Cohort Stratum will be analyzed separately.
Eligibility
Sex
ALL
Min age
—
Max age
—
Healthy volunteers
No
Inclusion Criteria:
Stratum A: Typical SCID (formerly referred to as Classic SCID)- -Subjects who meet the following inclusion criteria and the intention is to treat with allogeneic hematopoietic cell transplant (HCT) are eligible for enrollment into Stratum A (Typical SCID) of the study:
* Absence or very low number of T cells (CD3 T cells \<300/microliter) AND
* No or very low T cell function (\<10% of lower limit of normal) as measured by response to phytohemagglutinin (PHA) OR
* T cells of maternal origin present.
Stratum B: Leaky SCID, Omenn Syndrome, Reticular Dysgenesis-
-Subjects who meet the following criteria and the intention is to treat with HCT are eligible for enrollment into Stratum B:
Leaky SCID:
* Maternal lymphocytes tested for and not detected AND
* Either one or both of the following (a,b) :
* a.) \<50% of lower limit of normal T cell function as measured by response to PHA, OR response to anti-CD3/CD28 antibody
* b.) Absent or \<30% of lower limit of normal proliferative responses to candida and tetanus toxoid antigens
* AND at least two of the following (a through e):
* a.) Reduced number of CD3 T cells
* age ≤2 years: \<1500/microliter
* age \>2 years and ≤4 years: \<800/microliter
* age \>4 years: \<600/microliter
* b.) ≥80% of CD3+ or CD4+ T cells that are CD45RO+
* AND/OR \>80% of CD3+ or CD4+ T cells are CD62L negative
* AND/OR \>50% of CD3+ or CD4+T cells express HLA-DR (at \<4 years of age)
* AND/OR are oligoclonal T cells
* c.) Hypomorphic mutation in IL2RG in a male, or homozygous hypomorphic mutation or compound heterozygosity with ≥1 hypomorphic mutation in an autosomal SCID-causing gene
* d.) Low T Cell Receptor Excision Circles (TRECs) and/or the percentage of CD4+/45RA+/CD31+ or CD4+/45RA+/CD62L+ cells is below the lower limit of normal.
* e.) Functional testing in vitro supporting impaired, but not absent, activity of the mutant protein, AND
* Does not meet criteria for Omenn Syndrome.
Omenn Syndrome:
* Generalized skin rash
* Maternal lymphocytes tested for and not detected;
--Note: If maternal engraftment was not assessed and ruled out, the subject is not eligible as Omenn Syndrome.
* ≥80% of CD3+ or CD4+ T cells are CD45RO+ AND/OR
* 80% of CD3+ or CD4+T cells are CD62L negative AND/OR
* 50% of CD3+ or CD4+ T cells express HLA-DR (at \<2 years of age);
* Absent or low (\< 30% lower limit of normal) T cell proliferation response to antigens (Candida, tetanus) to which the subject has been exposed
NOTE: If proliferation to antigen was not performed, but at least 4 of the following 9 supportive criteria, at least one of which must be among those marked with an asterisk (\*) below are present, the subject is eligible as Omenn Syndrome:
* Hepatomegaly
* Splenomegaly
* Lymphadenopathy
* Elevated IgE
* Elevated absolute eosinophil count
* \*Oligoclonal T cells measured by CDR3 length or flow cytometry
* \*Proliferation to PHA is reduced \<50% of lower limit of normal or SI \<30
* \*Hypomorphic mutation in a SCID causing gene
* Low TRECS and/or the percentage of CD4+/45RA+/CD31+ or CD4+/45RA+/CD62L+ cells is below the lower limit of normal.
Reticular Dysgenesis:
* Absence or very low number of T cells (CD3 \<300/µL
* No or very low (\<10% lower limit of normal) T cell response to PHA
* Severe neutropenia (absolute neutrophil count \< 200 /µL) AND
* ≥2 of the following (a,b,c):
* a.) Sensori-neural deafness
* b.) Deficiency of marrow granulopoiesis on bone marrow examination
* c.) A pathogenic mutation in the adenylate kinase 2 (AK2) gene identified.
Stratum C:
Subjects who meet the following criteria and the intention is to treat with therapy other than allogeneic HCT, primarily PEG-ADA ERT or gene therapy with autologous modified (gene transduced) cells, are eligible for enrollment into
Stratum C:
* ADA Deficient SCID with intention to treat with PEG-ADA ERT
* ADA Deficient SCID with intention to treat with gene therapy
* X-linked SCID with intention to treat with gene therapy
* Any SCID patient previously treated with a thymus transplant (includes intention to treat with HCT, as well as PEG-ADA ERT or gene therapy)
* Any SCID patient who received therapy for SCID deemed "non-standard" or "investigational", including in utero procedures.
Exclusion Criteria:
-Subjects who meet any of the following exclusion criteria are disqualified from enrollment in Strata A, B, or C of the study:
* Presence of an Human Immunodeficiency Virus (HIV) infection (by PCR) or other cause of secondary immunodeficiency
* Presence of DiGeorge syndrome
* MHC Class I and MHC Class II antigen deficiency, and
* Metabolic conditions that imitate SCID or related disorders such as folate transporter deficiency, severe zinc deficiency or transcobalamin deficiency.
Primary outcome measure(s)
Overall Survival (OS) at Month 6 Post HCT — Month 6 Post HCT Assess the overall survival (OS) for participants after hematopoietic stem cell transplantation (HCT) for treatment of Severe Combined Immunodeficiency (SCID).
The time to this event is the time from HCT to death or last follow-up (whichever occurs first). All participants will be followed for a minimum of 6 months from HCT. Overall survival will be estimated at 6 months.
Overall Survival (OS) at Year 2 Post HCT — Year 2 Post HCT Assess the overall survival (OS) for participants after hematopoietic stem cell transplantation (HCT) for treatment of Severe Combined Immunodeficiency (SCID).
The time to this event is the time from HCT to death or last follow-up (whichever occurs first). All participants will be followed for a minimum of 6 months from HCT. Overall survival will be estimated at 2 years.
Overall Survival (OS) at Year 5 Post HCT — Year 5 Post HCT Assess the overall survival (OS) for participants after hematopoietic stem cell transplantation (HCT) for treatment of Severe Combined Immunodeficiency (SCID).
The time to this event is the time from HCT to death or last follow-up (whichever occurs first). All participants will be followed for a minimum of 6 months from HCT. Overall survival will be estimated at 5 years.
Overall Survival (OS) at Year 8 Post HCT — Year 8 Post HCT Assess the overall survival (OS) for participants after hematopoietic stem cell transplantation (HCT) for treatment of Severe Combined Immunodeficiency (SCID).
The time to this event is the time from HCT to death or last follow-up (whichever occurs first). All participants will be followed for a minimum of 6 months from HCT. Overall survival will be estimated at 8 years.
Trial sites (44)
Facility
City
Region
Status
University of Alabama at Birmingham
Birmingham
Alabama
Phoenix Children's Hospital
Phoenix
Arizona
Children's Hospital Los Angeles
Los Angeles
California
University of California, Los Angeles
Los Angeles
California
Lucile Salter Packard Children's Hospital at Stanford
Palo Alto
California
University of California San Francisco Children's Hospital
San Francisco
California
Children's Hospital Denver
Denver
Colorado
Alfred I. duPont Hospital for Children/Nemours
Wilmington
Delaware
Children's National Medical Center
Washington D.C.
District of Columbia
Johns Hopkins All Children's Hospital
St. Petersburg
Florida
Children's Healthcare of Atlanta/Emory University School of Medicine
Atlanta
Georgia
Ann & Robert H. Lurie Children's Hospital of Chicago
Chicago
Illinois
Children's Hospital/Louisiana State University Health Sciences Center
New Orleans
Louisiana
NIH Clinical Center Genetic Immunotherapy Section
Bethesda
Maryland
Children's Hospital Boston
Boston
Massachusetts
University of Michigan Health System
Ann Arbor
Michigan
University of Minnesota Medical Center
Minneapolis
Minnesota
Mayo Clinic Hospital
Rochester
Minnesota
Cardinal Glennon Children's Medical Center
St Louis
Missouri
Washington University St Louis Children's Hospital
St Louis
Missouri
Hackensack University Medical Center
Hackensack
New Jersey
Memorial Sloan-Kettering Cancer Center
New York
New York
University of Rochester Medical Center/ Golisano Children's Hospital
Rochester
New York
New York Medical College, Maria Fareri Children's Hospital
Valhalla
New York
Duke University
Durham
North Carolina
Cincinnati Children's Hospital Medical Center
Cincinnati
Ohio
University Hospitals-Rainbow Babies and Children's Hospital
Cleveland
Ohio
Nationwide Children's Hospital
Columbus
Ohio
Oregon Health and Science University
Portland
Oregon
The Children's Hospital of Philadelphia
Philadelphia
Pennsylvania
Children's Hospital of Pittsburgh of UPMC
Pittsburgh
Pennsylvania
St. Jude Children's Research Hospital
Memphis
Tennessee
University of Texas Southwestern Medical Center/Children's of Dallas
Dallas
Texas
Texas Children's Hospital
Houston
Texas
Methodist Children's Hospital of South Texas/Texas Transplant Institute
San Antonio
Texas
Primary Children's Medical Center/University of Utah
Salt Lake City
Utah
Seattle Children's Research Institute
Seattle
Washington
University of Wisconsin/ American Family Children's Hospital
Madison
Wisconsin
Medical College of Wisconsin
Milwaukee
Wisconsin
Alberta Children's Hospital
Calgary
Alberta
+ 4 more sites — see the full list on the official registry below.
More National Institute of Allergy and Infectious Diseases (NIAID) trials in Canada
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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