BD211: Genetically modified CD34+ autologous stem cells were transfused intravenously with single dosing.
Study summary
This study will be intented to evaluate the safety, tolerability, and engraftment efficacy after myeloablative preconditioning and transplantation of autologous CD34+ hematopoietic stem cells transduced with a lentiviral vector encoding the human βA-T87Q-globin gene in patients with transfusion-dependent (TDT) β-thalassemia.
Eligibility
Sex
ALL
Min age
3 Years
Max age
35 Years
Healthy volunteers
No
Inclusion Criteria:
1. Participants aged 3 years (inclusive) to 18 years (exclusive), with no gender restrictions.
2. Parents/legal guardians have fully understood and voluntarily signed a written informed consent form; and it is recommended that children aged 8 and above be involved in the decision to participate in this clinical trial and obtain a written consent form.
3. Transfusion-dependent β-thalassemia patients. "Transfusion-dependent" is defined as: requiring at least 100 mL/kg of packed red blood cells annually; the genotype can be β0/β0, β0/β+, or β+/β+, diagnosed through hemoglobin studies.
4. Eligible for allogeneic hematopoietic stem cell transplantation, but without a donor or those refusing to undergo allogeneic hematopoietic stem cell transplantation.
5. Have undergone symptomatic treatment for at least the past 2 years and have retained medical records including transfusion history.
6. Stable condition and maintained an appropriate iron chelation regimen.
7. Good status of organ function.
8. Good compliance from the individual and parents/legal guardians, willing to adhere to visit schedules, trial plans, laboratory tests, and other trial procedures as stipulated in this protocol.
9. Willing to participate in long-term follow-up research.
Exclusion Criteria:
1. Has a fully HLA-matched hematopoietic stem cell donor and is willing to receive a fully HLA-matched hematopoietic stem cell transplant. Enrollment is otherwise only advised after review by the safety review committee.
2. Positive for antibodies against Human Immunodeficiency Virus 1/2 (HIV-1/HIV-2), Treponema pallidum (TP) specific antibodies, Human T-lymphotropic Virus 1 or 2 (HTLV-1/HTLV-2) antibodies, and Vesicular Stomatitis Virus G (VSV-G).
3. Positive for Hepatitis B Virus (HBV) HbsAg or HBV-DNA; Hepatitis C Virus (HCV) HCAb positive; positive nucleic acid test for Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV).
4. Severe active bacterial, viral, fungal, malarial, or parasitic infections.
5. Has had, or currently has, a malignant, myeloproliferative, or immunodeficiency disorder.
6. Direct relatives with known or suspected hereditary cancer syndromes (including but not limited to breast cancer, colorectal cancer, ovarian cancer, prostate cancer, and pancreatic cancer).
7. Autoimmune diseases that could result in transfusion difficulties.
8. Major organ diseases or abnormal lab tests, including:
1. Liver cirrhosis, fibrosis, or active hepatitis, and/or abnormal liver function tests (Serum total bilirubin (TBIL) ≥ 1.5x Upper Limit of Normal (ULN); Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) ≥ 2.5x ULN; Alkaline phosphatase ≥ 2.5x ULN).
2. Heart disease, or Left Ventricular Ejection Fraction (LVEF) \< 60%.
3. Kidney diseases, or serum creatinine ≥ 1.5ULN, creatinine clearance rate \< 30% of the normal level (measured or calculated by the Cockcroft-Gault equation).
4. Endocrine disorders, such as insulin-dependent diabetes, hyperthyroidism, or hypothyroidism.
5. Severe iron overload, serum ferritin ≥ 5000 ng/mL.
6. Cardiac T2\* \< 20 ms, and/or liver iron content (LIC) ≥ 15mg/g liver weight by MRI.
7. Significant pulmonary hypertension diagnosed clinically according to guidelines, requiring clinical medical intervention.
9. Uncorrected bleeding disorders.
10. Severe psychiatric disorders.
11. Peripheral blood white cell (WBC) count \< 3x10\^9/L or platelets count \< 120x10\^9/L.
12. Received hydroxyurea treatment within the last 3 months before stem cell collection.
13. Used erythropoiesis-stimulating agents within the 3 months prior to HSC collection.
14. History of allogeneic transplantation.
15. Previously received any type of gene and/or cell therapy.
16. Participating in another clinical trial and is within a 30-day screening period.
17. Has contraindications to anesthesia.
18. Has contraindications to hematopoietic stem cell collection.
19. Allergic to the investigational drug or its excipients.
20. Any other conditions determined by the investigator as unsuitable for participation in this clinical trial.
Primary outcome measure(s)
Mean time from BD211 treatment to successful neutrophil engraftment, as well as the number and percentage of participants with successful neutrophil engraftment. — 18 months Definition of successful neutrophil engraftment: A consistent absolute neutrophil count (ANC) recovery of ≥0.5×10\^9/L over three consecutive days.
Mean time from BD211 treatment to successful platelet engraftment, as well as the number and percentage of participants with successful platelet engraftment. — 18 months Definition of successful platelet engraftment: No platelet transfusion for 7 days with platelet counts of ≥20×10\^9/L in three consecutive measurements.
Proportion of participants achieving transfusion independence (TI) — 18 months TI defined as "hemoglobin (Hb) ≥ 90g/L without any transfusion of packed red blood cells (pRBCs) for 12 months at any time during the study period after BD211 treatment"; proportion of participants with TI = number of participants with TI ÷ total number of BD211 treatment.
Trial sites (3)
Facility
City
Region
Status
Sun Yat-sen Memorial Hospital
Guangzhou
Guandong
Recruiting
The First Affiliated Hospital of Guangxi Medical University
Nanning
Guangxi
Recruiting
Shanghai Ruijin Hospital, Shanghai Jiaotong University
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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