Original articles

Transplantation of gene-modified haematopoietic stem cells: Application and clinical considerations

M Alessandrini, K-H Krause, R F Speck, M S Pepper

Abstract


Autologous and allogeneic haematopoietic stem cell (HSC) transplantation has been performed in patients with various malignant and non-malignant haematological disorders for more than 50 years. Ex vivo gene modification of HSCs for autologous transplantation opens up new therapeutic avenues for genetic and infectious diseases. Major advances have been made over the last three decades with respect to gene modification of HSCs and transplantation strategies, ultimately culminating in the approval of two such therapies in Europe (Strimvelis for a rare primary immune deficiency, and LentiGlobin for beta-thalassaemia). Newer gene-modifying technologies and treatment regimens have also recently come to the fore, which hold great promise for the development of safer and more effective treatments. We provide an overview of the current state of gene-modified HSC therapies, highlighting success stories, limitations and important considerations for achieving successful translation of these therapies to the clinic.


Authors' affiliations

M Alessandrini, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Switzerland

K-H Krause, Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Switzerland

R F Speck, Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Switzerland

M S Pepper, SAMRC Extramural Unit for Stem Cell Research and Therapy, Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, South Africa

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Cite this article

South African Medical Journal 2019;109(8b):64-69. DOI:10.7196/SAMJ.2019.v109i8b.013910

Article History

Date submitted: 2019-09-10
Date published: 2019-09-10

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