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Blood, 15 December 2008, Vol. 112, No. 13, pp. 4853-4861.
Prepublished online as a Blood First Edition Paper on September 23, 2008; DOI 10.1182/blood-2008-05-156356.
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Submitted May 12, 2008
Accepted August 29, 2008
In vivo proliferation advantage of genetically corrected hematopoietic stem cells in a mouse model of Fanconi anemia FA-D1
Paula Rio, Nestor W. Meza, Africa Gonzalez-Murillo, Susana Navarro, Lara Alvarez, Jordi Surralles, Maria Castella, Guillermo Guenechea, Jose C. Segovia, Helmut Hanenberg, and Juan A. Bueren*
Hematopoiesis and Gene Therapy Division, CIEMAT / CIBER-ER, Madrid, Spain
LABIEMET, School of Medicine of Tachira, Universidad de los Andes, San Cristobal, Venezuela
Department of Genetics and Microbiology, Universitat Autonoma de Barcelona and CIBER-ER, Barcelona, Spain
Department of Pediatric Oncology, Hematology and Immunology, Children's Hospital, Duesseldorf, Germany
* Corresponding author; email: juan.bueren{at}ciemat.es.
Fanconi anemia (FA) is an inherited recessive DNA repair disorder mainly characterized by bone marrow failure and cancer predisposition. Studies in mosaic FA patients have shown that reversion of one inherited germ-line mutation resulting in a functional allele in one or a few hematopoietic stem cells (HSCs) can lead to the proliferation advantage of corrected cells, thus over time normalizing the hematological status of the patient. In contrast to these observations, it is still unclear whether the ex vivo genetic correction of FA HSCs also provides a similar proliferation advantage to FA HSCs. Using a FA mouse model with a marked hematopoietic phenotype, the FA-D1 (Brca2 27/ 27) mice, we demonstrate that the lentivirus-mediated gene therapy of FA HSCs results in the progressive expansion of genetically corrected clones in mild-conditioned FA-D1 recipients. Consistent with this data, hematopoietic progenitors from FA recipients progressively became mitomycin C resistant and their chromosomal instability was reverted. No evidences of myelodysplasia, leukemias or abnormal clonal repopulation patterns were observed at multiple time points in primary or secondary recipients. Our results demonstrate that the ectopic expression of BRCA2 confers a beneficial in vivo proliferation advantage to FA-D1 HSCs that enables the full hematopoietic repopulation of FA recipients with genetically corrected cells.

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