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This is a single-arm, open-label, single-dose, dose-escalation trial that plans to enrol 3-18 patients with transfusion-dependent β-thalassaemia (TDT) or sickle-cell disease (SCD). Its primary aims are to evaluate the safety and tolerability of a single administration of YOLT-204 and to obtain preliminary data on its effect on plasma fetal-haemoglobin levels. The main-study screening period may last up to 60 days; the treatment day is Day 0 (D0). Safety follow-up continues through Week 52 post-dose. After completion of the main study, participants will enter long-term follow-up extending to 15 years post-dose.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arms | Experimental | The intervention group will receive YOLT-204 on day0 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| YOLT-204 | Drug | The intervention group will receive YOLT-204 on day0 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Adverse event rate | Calculate the rate of various adverse events | From baseline to 52 weeks after dose |
| 3 months of sustained transfusion reduction | Analysis begins one month after treatment with YOLT-204, and the proportion of patients who achieve at least 3 months of sustained transfusion reduction (sustained TR3) is obtained. | From baseline to 52 weeks after dose |
| 3 months of sustained HbF level ≥20% | Proportion of patients who, starting one month after YOLT-204 treatment and without concomitant hydroxyurea, maintain HbF ≥ 20 % for at least three consecutive months. | From baseline to 52 weeks after dose |
| Measure | Description | Time Frame |
|---|---|---|
| The proportion of alleles with intended modifications | The proportion of alleles with intended modifications in peripheral blood leukocytes and bone marrow cells | From baseline to 52 weeks after dose |
| Concentration of Hemoglobin |
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Inclusion Criteria:
Exclusion Criteria:
1.History of multiple drug allergies or hypersensitivity to oligonucleotides or lipid nanoparticles (LNP).
2.Clinically significant active bacterial, viral, fungal, or parasitic infection at screening, as judged by the investigator.
3.White blood cell (WBC) count < 3 × 10⁹/L and/or platelet count < 100 × 10⁹/L at screening.
4.Uncorrected bleeding diathesis. 5.Massive splenomegaly at screening (spleen edge below the umbilicus or > 4 cm below the costal margin) deemed by the investigator to preclude enrollment.
6.Serum ferritin ≥ 5 000 ng/mL, or MRI T2* evidence of severe cardiac or hepatic iron overload.
7.Positive for hepatitis B surface antigen (HBsAg), anti-hepatitis C virus antibody, anti-HIV antibody, or specific anti-Treponema pallidum antibody.
8.Prior hematopoietic stem-cell transplantation, gene therapy, or gene-editing therapy.
9.Participation in another clinical trial and receipt of investigational product within 3 months before first dose of study drug.
10.Current or prior malignancy, myeloproliferative disorder, or immunodeficiency disease.
11.Severe psychiatric illness precluding cooperation; clinically significant pulmonary hypertension requiring medical intervention; recent malaria; first-degree relative with hematologic malignancy.
12.Positive pregnancy test, pregnancy, or lactation in female subjects at screening.
13.Any condition (past or present) that, in the investigator's opinion, could confound results, compromise participation, or render the patient unsuitable for the study.
14.Use within 3 months before study drug: erythropoietin (EPO), thalidomide, hydroxyurea, luspatercept, or similar agents.
15.In subjects ≥ 12 years, abnormal transcranial Doppler (TCD) with middle cerebral or internal carotid artery velocity ≥ 200 cm/s.
16.History of moyamoya disease or imaging findings consistent with moyamoya at screening, assessed by the investigator as conferring bleeding risk.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jiang Hua | Contact | +8613533330985 | jiang_hua18@sina.cn | |
| Gong Wei Wei | Contact | +8615336388770 | sdgongww@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Guangzhou women and children's medical center | Guangzhou | Guangdong | 510405 | China |
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| ID | Term |
|---|---|
| D006453 | Hemoglobinopathies |
| D000755 | Anemia, Sickle Cell |
| ID | Term |
|---|---|
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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The concentration of Hemoglobin was measured by laboratory
| From baseline to 52 weeks after dose |
| Concentration of Fetal hemoglobin | The concentration of Fetal hemoglobin was measured by laboratory | From baseline to 52 weeks after dose |
| Concentration of proportion of F cell | The proportion of F cell was measured by laboratory | From baseline to 52 weeks after dose |
| 3 months of transfusion independence | Analysis begins one month after treatment with YOLT-204, and the proportion of patients who achieve at least 3 months of transfusion independence (sustained TI3) is obtained. | From baseline to 52 weeks after dose |
| 6 months of sustained transfusion reduction | Analysis begins one month after treatment with YOLT-204, and the proportion of patients who achieve at least 6 months of sustained transfusion reduction (sustained TR6) is obtained. | From baseline to 52 weeks after dose |
| 6 months of transfusion independence | Analysis begins one month after treatment with YOLT-204, and the proportion of patients who achieve at least 6 months of transfusion independence (sustained TI6) is obtained. | From baseline to 52 weeks after dose |
| Free of hospitalization due to vaso-occlusive crisis | Analysis begins one month after treatment with YOLT-204, and the proportion of patients who remained free of hospitalization due to vaso-occlusive crisis. | From baseline to 52 weeks after dose |
| Free of any vaso-occlusive crisis | Analysis begins one month after treatment with YOLT-204, and the proportion of patients who remained free of any vaso-occlusive crisis | From baseline to 52 weeks after dose |
| Change of red-blood-cell transfusions given | Analysis begins one month after treatment with YOLT-204, and the Change from baseline in volume of red-blood-cell transfusions given for SCD-related indications | From baseline to 52 weeks after dose |
| The number of vaso-occlusive crises | Change from baseline in the number of vaso-occlusive crises within 1 year after YOLT-204 treatment. | From baseline to 52 weeks after dose |
| D000745 | Anemia, Hemolytic, Congenital |
| D000743 | Anemia, Hemolytic |
| D000740 | Anemia |