Gene Therapy for WHIM Syndrome

SS
Overseen BySuk S De Ravin, M.D.
Age: Any Age
Sex: Any
Trial Phase: Phase 1 & 2
Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a groundbreaking gene therapy for individuals with WHIM syndrome, a rare immune disorder that causes serious infections. The treatment collects a person's stem cells, edits the faulty gene, and returns the modified cells, potentially curing the disorder. Eligible participants must have WHIM syndrome confirmed by a specific gene mutation and have experienced related symptoms, such as frequent infections. As a Phase 1 trial, this research aims to understand how the treatment works in people, offering participants the opportunity to be among the first to receive this innovative therapy.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the study team or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Studies have shown that specially edited blood stem cells could safely treat WHIM syndrome. Research indicates that gene editing tools, such as CRISPR/Cas9, can deactivate the gene causing the disease in these cells. This method aims to correct the genetic issue behind WHIM syndrome, allowing the edited cells to grow and develop normally over time.

In earlier studies, this type of gene editing was well-tolerated, with few side effects. Researchers have improved the precision and safety of this process, reducing risks. These advancements suggest that the treatment could be a safe option for people with WHIM syndrome. However, as this trial remains in its early stages, ongoing monitoring will be crucial to ensure long-term safety.12345

Why do researchers think this study treatment might be promising?

Unlike the standard treatments for WHIM Syndrome, such as antibiotics and granulocyte colony-stimulating factors (G-CSF), which primarily manage symptoms, this gene therapy uses base-edited hematopoietic stem and progenitor cells (HSPCs) to address the root cause of the condition. Researchers are excited because this therapy could potentially provide a one-time, long-lasting solution by correcting the genetic mutation responsible for WHIM Syndrome. This innovative approach could lead to fewer infections and improved immune function, offering hope for a more effective and sustainable treatment option.

What evidence suggests that this treatment might be an effective treatment for WHIM syndrome?

Research has shown that specially edited stem cells might help treat WHIM syndrome. This gene therapy corrects the faulty CXCR4 gene responsible for the condition. Studies have found that this approach can reduce issues such as frequent infections and warts. In similar conditions, like sickle cell disease, this method has proven effective and reliable. This suggests that the treatment could lead to lasting improvements for people with WHIM syndrome. Participants in this trial will receive a one-time infusion of base-edited autologous hematopoietic stem and progenitor cells after myeloid conditioning with busulfan.13467

Who Is on the Research Team?

SS

Suk S De Ravin, M.D.

Principal Investigator

National Institute of Allergy and Infectious Diseases (NIAID)

Are You a Good Fit for This Trial?

This trial is for people aged 3 and older who have WHIM syndrome, a rare immune disorder caused by a CXCR4 gene mutation. Participants should be able to undergo stem cell collection and hospital treatment.

Inclusion Criteria

Medical lab data (historical) of neutropenia, or B cell dysfunction (low or absent IgG levels, or on IV gamma globulin)
Must be willing to have blood and tissue samples stored
Expected survival of at least 120 days
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Exclusion Criteria

I do not have severe liver problems unless my doctor has approved a plan for them.
Coagulation dysfunction with Prothrombin INR or Partial thromboplastin time > 2 x ULN (patients on controlled anticoagulation agents not excluded for therapeutic levels)
My kidney function is severely reduced.
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Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 or more visits (in-person)

Apheresis

Blood is taken to separate out stem cells, which will undergo gene editing

1 week
1 visit (in-person)

Treatment

Participants receive conditioning drugs and the edited stem cells are infused

4 weeks
Inpatient stay

Follow-up

Participants are monitored for safety and effectiveness after treatment

5 years
8 visits (in-person)

Long-term Follow-up

Participants continue to be monitored for long-term safety and efficacy

15 years

What Are the Treatments Tested in This Trial?

Interventions

  • Base-edited hematopoietic stem and progenitor cells
  • Busulfan
  • Filgrastim
  • Palifermin
  • Plerixafor

Trial Overview

Researchers are testing if editing a person's own stem cells to fix the faulty CXCR4 gene can cure WHIM syndrome. The process involves collecting, editing, and returning these cells after preparing the body with certain medications.

How Is the Trial Designed?

1

Treatment groups

Experimental Treatment

Group I: Single arm studyExperimental Treatment5 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

National Institute of Allergy and Infectious Diseases (NIAID)

Lead Sponsor

Trials
3,361
Recruited
5,516,000+

Citations

Base-Edited Hematopoietic Stem/Progenitor Cell Gene ...

Clinical efficacy: Improvement from baseline problems such as recurrent infection, wart burden, gastrointestinal complaints, or immune ...

Base editing of hematopoietic stem cells rescues sickle ... - PMC

These findings suggest a one-time autologous treatment for SCD that eliminates pathogenic HBBS, generates benign HBBG, and minimizes undesired consequences of ...

Base-Edited Hematopoietic Stem/Progenitor Cell Gene ...

Clinical efficacy: Improvement from baseline problems such as recurrent infection, wart burden, gastrointestinal complaints, or immune ...

CRISPR/Cas9-mediated Cxcr4 disease allele inactivation for ...

WHIM allele inactivation through gene editing may be a safe genetic cure strategy for the disease.

Base-Edited Stem Cell Gene Therapy for CXCR4-WHIM ...

This study aims to evaluate the safety of a gene therapy using base-edited autologous hematopoietic stem and progenitor cells in individuals ...

CRISPR/Cas9-mediated Cxcr4 disease allele inactivation for ...

WHIM allele inactivation through gene editing may be a safe genetic cure strategy for inactivated HSCs retained long-term pluripotency and selective ...

Hematopoietic stem and progenitors cells gene editing

Improving gene editing outcomes in human hematopoietic stem and progenitor cells by temporal control of DNA repair. Long-term safety and efficacy of lentiviral ...