Keyword: Transfusion Independence
1 result found.
Review Article
Australian Journal of Biomedical Research, 2(1), 2026, aubm012, https://doi.org/10.63946/aubiomed/17736
ABSTRACT:
Background: Sickle cell disease (SCD) and transfusion-dependent β-thalassemia (TDT) remain major global health burdens. Ex vivo gene-editing therapies aim to achieve durable fetal hemoglobin (HbF) induction or direct mutation correction.
Methods: We systematically reviewed clinical studies of CRISPR-Cas9 or base-editing therapies for SCD and TDT (MEDLINE, EMBASE, Web of Science, ClinicalTrials.gov, conference proceedings; 2010–03 December 2025). Eleven studies (>170 treated patients) reporting post-infusion outcomes were included.
Results: All therapies produced robust, pancellular HbF (30–65%) and total hemoglobin in/near the normal range. In TDT (n > 100 evaluable), transfusion independence (≥12 months, Hb ≥9 g/dL) was achieved in 89–100% across platforms, sustained up to >4 years. In SCD (n > 60 evaluable), adjudicated vaso-occlusive crises were eliminated for ≥12 months in ≥97% of patients treated with exagamglogene autotemcel and 100% in smaller cohorts (EDIT-301, BEAM-101). No graft failures occurred. Serious adverse events and one death were attributable to busulfan conditioning, not editing. No therapy-related malignancies or confirmed harmful off-target edits have been reported, although follow-up remains limited (median ~18 months, longest >4 years).
Conclusion: Current evidence from phase 1–3 trials demonstrates that ex vivo gene editing can achieve functional cure for many patients with TDT and severe SCD. Conditioning-related toxicity, limited long-term safety data, and delivery complexity remain critical barriers to broader implementation.
Methods: We systematically reviewed clinical studies of CRISPR-Cas9 or base-editing therapies for SCD and TDT (MEDLINE, EMBASE, Web of Science, ClinicalTrials.gov, conference proceedings; 2010–03 December 2025). Eleven studies (>170 treated patients) reporting post-infusion outcomes were included.
Results: All therapies produced robust, pancellular HbF (30–65%) and total hemoglobin in/near the normal range. In TDT (n > 100 evaluable), transfusion independence (≥12 months, Hb ≥9 g/dL) was achieved in 89–100% across platforms, sustained up to >4 years. In SCD (n > 60 evaluable), adjudicated vaso-occlusive crises were eliminated for ≥12 months in ≥97% of patients treated with exagamglogene autotemcel and 100% in smaller cohorts (EDIT-301, BEAM-101). No graft failures occurred. Serious adverse events and one death were attributable to busulfan conditioning, not editing. No therapy-related malignancies or confirmed harmful off-target edits have been reported, although follow-up remains limited (median ~18 months, longest >4 years).
Conclusion: Current evidence from phase 1–3 trials demonstrates that ex vivo gene editing can achieve functional cure for many patients with TDT and severe SCD. Conditioning-related toxicity, limited long-term safety data, and delivery complexity remain critical barriers to broader implementation.
