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| ID | Type | Description | Link |
|---|---|---|---|
| 17IC04 | Other Identifier | UCL Great Ormond Street Institute of Child Health |
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| Name | Class |
|---|---|
| Orchard Therapeutics | INDUSTRY |
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This is a prospective, non-randomized, single-cohort, longitudinal, single-center, clinical study designed to assess the efficacy and safety of a cryopreserved formulation of OTL-101 (autologous CD34+ hematopoietic stem/progenitor cells transduced ex vivo with EFS (Elongation Factor 1α Short form) Lentiviral Vector (LV) encoding for the human ADA gene) administered to ADA-SCID subjects between the ages of >/=30 days and <18 years of age, who are not eligible for an Human Leukocyte Antigen (HLA) matched sibling/family donor and meeting the inclusion/exclusion criteria. The OTL-101 product is infused after a minimal interval of at least 24 hours following the completion of reduced intensity conditioning. For subjects who successfully receive the OTL-101 product, pegademase bovine (PEG-ADA) Enzyme Replacement Therapy (ERT) is discontinued at Day+30 (-3/+15) after the transplant. After their discharge from hospital, the subjects will be seen at regular intervals to review their history, perform examinations and draw blood samples to assess immunity and safety.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gene Therapy | Experimental | Infusion of autologous cryopreserved EFS-ADA LV CD34+ cells |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Infusion of autologous cryopreserved EFS-ADA LV CD34+ cells (OTL-101) | Genetic | Autologous cryopreserved EFS-ADA LV CD34+ cells (OTL-101) are infused intravenously |
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival at 12 months post OTL-101 infusion | Overall survival is defined as the proportion of subjects alive | 12 Months |
| Event free survival at 12 months post OTL-101 infusion | Event-free survival is defined as the proportion of subjects alive with no "event", an "event" being the resumption of Peg-Ada ERT or the need for a rescue stem cell transplant (SCT), or death | 12 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival at 24 months post OTL-101 infusion | Overall survival is defined as the proportion of subjects alive | 24 months |
| Event free survival at 24 months post OTL-101 infusion | Event-free survival is defined as the proportion of subjects alive with no "event", an "event" being the resumption of Peg-Ada ERT or the need for a rescue stem cell transplant (SCT), or death |
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Inclusion Criteria:
Provision of written informed consent prior to any study related procedures. In this study consent must be provided by the parents/legal guardians and, where applicable according to local laws, a signed assent from the child
Subjects ≥30 days and <18 years of age,
With a diagnosis of ADA-SCID based on:
Lymphopenia (absolute lymphocyte count <400 cells/mL) OR absence or low number of T-cells (absolute CD3+ count < 300 cells/mL), or
Severely decreased T lymphocyte blastogenic responses to phytohemagglutinin (either <10% of lower limit of normal controls for the diagnostic laboratory, or <10% of the response of the normal control of the day, or stimulation index <10), or
Identification of SCID by neonatal screening revealing low T cell Receptor Excision Circle (TREC) levels.
Ineligible for or with no available matched family donor for allogeneic Bone Marrow (BM) transplantation, defined as the absence of a medically eligible HLA-identical sibling or family donor, with normal immune function, who could serve as an allogeneic bone marrow donor.
Females of child-bearing age will be required to provide a negative pregnancy test 30 days prior to Visit 2.
Subjects and their parents/legal guardians must be willing and able to comply with study restrictions and to remain at the clinic for the required duration during the study period and willing to return to the clinic for the follow up evaluation as specified in the protocol.
Exclusion Criteria:
Ineligible for autologous hematopoietic stem cell (HSC) procedure.
Other conditions which in the opinion of the Principal Investigator and/or Co-Investigators, contraindicate the harvest of bone marrow, the administration of Busulfan and the infusion of transduced cells, or which indicate an inability of the subject or subject's parent/legal guardian to comply with the protocol.
Haematologic abnormality, defined as:
Anaemia (Hb <8.0 g/dl). Evidence of bi/trilineage cytopaenia (haemoglobin <8 g/dl, neutrophils <0.5 x 109/L, platelets 50 x 109/L). Thrombocytopaenia (platelet count <50,000/mm3). Prothrombin time or partial thromboplastin time (PTT) >2 x upper limit of normal (ULN) (subjects with a correctable deficiency controlled on medication will not be excluded).
Pulmonary abnormality, defined as:
Cardiac abnormality, defined as:
Neurologic abnormality, defined as:
Known history of significant renal abnormality.
Known history of significant hepatic or gastrointestinal abnormality.
Oncologic disease, defined as:
Known sensitivity to Busulfan.
Confirmation of an infectious disease by deoxyribonucleic acid (DNA) polymerase chain reactions (PCR) positive at time of screening assessment according to local protocols/procedures (including HIV-1 and hepatitis B).
The subject is pregnant or has a major congenital anomaly.
Is likely to require treatment during the study with drugs that are not permitted by the study protocol.
The subject has previously received another form of gene therapy.
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| Name | Affiliation | Role |
|---|---|---|
| Claire Booth, Dr | Great Ormond Street Hospital NHS Foundation Trust | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Great Ormond Street Hospital for Children NHS Foundation Trust | London | WC1N 3JH | United Kingdom |
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| Busulfan | Drug | Busulfan is used for non-myeloablative conditioning |
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| Peg-Ada | Drug | Peg-Ada Enzyme Replacement Therapy (ERT) is discontinued at Day +30 (-3/+15 days) after successful engraftment |
|
| 24 Months |
| Safety evaluation including infection rates | 12 and 24 months |
| Safety evaluation including performance outcomes | 12 and 24 months |
| Safety evaluation including immune reconstitution | 12 and 24 months |
| ID | Term |
|---|---|
| C531816 | Severe combined immunodeficiency due to adenosine deaminase deficiency |
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| ID | Term |
|---|---|
| D002066 | Busulfan |
| C051409 | pegademase bovine |
| ID | Term |
|---|---|
| D002072 | Butylene Glycols |
| D006018 | Glycols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D008698 | Mesylates |
| D000476 | Alkanesulfonates |
| D017738 | Alkanesulfonic Acids |
| D000473 | Alkanes |
| D006839 | Hydrocarbons, Acyclic |
| D006838 | Hydrocarbons |
| D013451 | Sulfonic Acids |
| D013456 | Sulfur Acids |
| D013457 | Sulfur Compounds |
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