Transfer of gene-corrected autologous hematopoietic stem cells in patients with primary immunodeficiencies has emerged as a new therapeutic approach. Patients with various conditions lacking a suitable donor have been treated with retroviral vectors and a gene-addition strategy. Initial promising results were shadowed by the occurrence of malignancies in some of these patients. Current trials, developed in the last decade, use safer viral vectors to overcome the risk of genotoxicity and have led to improved clinical outcomes. This review reflects the progresses made in specific disorders, including adenosine deaminase deficiency, X-linked severe combined immunodeficiency, chronic granulomatous disease, and Wiskott-Aldrich syndrome.
Key points
- •
Ex vivo gene transfer can be used in different primary immune disorders.
- •
Initial results were tempered by genotoxicity associated with the gammaretroviral design.
- •
New “safer” vector designs combined with nonmyeloablative or fully myeloablative conditioning regimens allow enhanced engraftment and efficient transgene expression, while maintaining a robust safety profile.

Stay updated, free articles. Join our Telegram channel

Full access? Get Clinical Tree


