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Blood, 15 November 2006, Vol. 108, No. 10, pp. 3313-3320.
Prepublished online as a Blood First Edition Paper on July 25, 2006; DOI 10.1182/blood-2006-03-006908.


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GENE THERAPY

Correction of the disease phenotype in canine leukocyte adhesion deficiency using ex vivo hematopoietic stem cell gene therapy

Thomas R. Bauer, Jr, Mehreen Hai, Laura M. Tuschong, Tanya H. Burkholder, Yu-chen Gu, Robert A. Sokolic, Cole Ferguson, Cynthia E. Dunbar, and Dennis D. Hickstein

From the Experimental Transplantation and Immunology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health (NIH); the Division of Veterinary Resources, Office of Research Services, NIH; and the Molecular Hematopoiesis Section, Hematology Branch, National Heart, Lung, Blood Institute, NIH, Bethesda, MD.

Canine leukocyte adhesion deficiency (CLAD) represents the canine counter-part of the human disease leukocyte adhesion deficiency (LAD). Defects in the leukocyte integrin CD18 adhesion molecule in both CLAD and LAD lead to recurrent, life-threatening bacterial infections. We evaluated ex vivo retroviral-mediated gene therapy in CLAD using 2 nonmyeloablative conditioning regimens—200 cGy total body irradiation (TBI) or 10 mg/kg busulfan—with or without posttransplantation immunosuppression. In 6 of 11 treated CLAD dogs, therapeutic levels of CD18+ leukocytes were achieved. Conditioning with either TBI or busulfan allowed long-term engraftment, and immunosuppression was not required for efficacy. The percentage of CD18+ leukocytes in the peripheral blood progressively increased over 6 to 8 months after infusion to levels ranging from 1.26% to 8.37% at 1-year follow-up in the 6 dogs. These levels resulted in reversal or moderation of the severe CLAD phenotype. Linear amplification–mediated polymerase chain reaction assays indicated polyclonality of insertion sites. These results describe ex vivo hematopoietic stem cell gene transfer in a disease-specific, large animal model using 2 clinically applicable conditioning regimens, and they provide support for the use of nonmyeloablative conditioning regimens in preclinical protocols of retroviral-mediated gene transfer for nonmalignant hematopoietic diseases such as LAD.


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