CRISPR-Cas9 Gene Editing for Sickle Cell Disease and β-Thalassemia

  • Frangoul, Haydar M.D.
  • Altshuler, David M.D., Ph.D.
  • Cappellini, Domenica M. M.D.
  • Chen, Yi-Shan Ph.D.
  • Domm, Jennifer M.D.
  • Eustace, Brenda K. Ph.D.
  • Foell, Juergen M.D.
  • de la Fuente, Josu M.D., Ph.D.
  • Grupp, Stephan M.D., Ph.D.
  • Handgretinger, Rupert M.D.
  • Ho, Tony W. M.D.
  • Kattamis, Antonis M.D.
  • Kernytsky, Andrew Ph.D.
  • Lekstrom-Himes, Julie M.D.
  • Li, Amanda M. M.D.
  • Locatelli, Franco M.D.
  • Mapara, Markus Y. M.D., Ph.D.
  • de Montalembert, Mariane M.D.
  • Rondelli, Damiano M.D.
  • Sharma, Akshay M.B., B.S.
  • Sheth, Sujit M.D.
  • Soni, Sandeep M.D.
  • Steinberg, Martin H. M.D.
  • Wall, Donna M.D.
  • Yen, Angela Ph.D.
  • Corbacioglu, Selim M.D.
New England Journal of Medicine 384(3):p 252-260, January 21, 2021. | DOI: 10.1056/NEJMoa2031054

Abstract

Transfusion-dependent β-thalassemia (TDT) and sickle cell disease (SCD) are severe monogenic diseases with severe and potentially life-threatening manifestations. BCL11A is a transcription factor that represses γ-globin expression and fetal hemoglobin in erythroid cells. We performed electroporation of CD34+ hematopoietic stem and progenitor cells obtained from healthy donors, with CRISPR-Cas9 targeting the BCL11A erythroid-specific enhancer. Approximately 80% of the alleles at this locus were modified, with no evidence of off-target editing. After undergoing myeloablation, two patients — one with TDT and the other with SCD — received autologous CD34+ cells edited with CRISPR-Cas9 targeting the same BCL11A enhancer. More than a year later, both patients had high levels of allelic editing in bone marrow and blood, increases in fetal hemoglobin that were distributed pancellularly, transfusion independence, and (in the patient with SCD) elimination of vaso-occlusive episodes. (Funded by CRISPR Therapeutics and Vertex Pharmaceuticals; ClinicalTrials.gov numbers, NCT03655678 for CLIMB THAL-111 and NCT03745287 for CLIMB SCD-121.)

CRISPR-Cas9 Gene Editing for Sickle Cell Disease and β-Thalassemia

  • Meisel, Roland M.D.
New England Journal of Medicine 384(23):p e91(1), June 10, 2021. | DOI: 10.1056/NEJMc2103481

Corresponding Article

Induction of Fetal Hemoglobin by Gene Therapy

  • Walters, Mark C. M.D.
New England Journal of Medicine 384(3):p 284-285, January 21, 2021. | DOI: 10.1056/NEJMe2034338

Treatment by CRISPR-Cas9 Gene Editing — A Proof of Principle

  • Malech, Harry L. M.D.
New England Journal of Medicine 384(3):p 286-287, January 21, 2021. | DOI: 10.1056/NEJMe2034624

Post-Transcriptional Genetic Silencing ofBCL11Ato Treat Sickle Cell Disease

  • Esrick, Erica B. M.D.
  • Lehmann, Leslie E. M.D.
  • Biffi, Alessandra M.D., Ph.D.
  • Achebe, Maureen M.D.
  • Brendel, Christian Ph.D.
  • Ciuculescu, Marioara F. M.D.
  • Daley, Heather B.S.
  • MacKinnon, Brenda B.S.N., R.N.
  • Morris, Emily M.P.H.
  • Federico, Amy C.P.N.P.
  • Abriss, Daniela Ph.D.
  • Boardman, Kari B.S.
  • Khelladi, Radia B.S.
  • Shaw, Kit Ph.D.
  • Negre, Helene Ph.D.
  • Negre, Olivier Ph.D.
  • Nikiforow, Sarah M.D., Ph.D.
  • Ritz, Jerome M.D.
  • Pai, Sung-Yun M.D.
  • London, Wendy B. Ph.D.
  • Dansereau, Colleen M.S.N., R.N., C.P.N.
  • Heeney, Matthew M. M.D.
  • Armant, Myriam Ph.D.
  • Manis, John P M.D.
  • Williams, David A. M.D.
New England Journal of Medicine 384(3):p 205-215, January 21, 2021. | DOI: 10.1056/NEJMoa2029392
Copyright © 2021 Massachusetts Medical Society. All rights reserved.
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