Submitted October 31, 2008
Accepted April 1, 2009
Amelioration of murine 
-thalassemia through drug selection of hematopoietic stem cells transduced with a lentiviral vector encoding both 
-globin and the MGMT drug resistance gene
Huifen Zhao, Tamara I. Pestina, Md Nasimuzzaman, Perdeep Mehta, Phillip W. Hargrove, and Derek A. Persons*
Division of Experimental Hematology, Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, United States
Bioinformatics Division, Department of Information Sciences, St. Jude Children's Research Hospital, Memphis, TN, United States
* Corresponding author; email: derek.persons{at}stjude.org.
Correction of murine models of 
-thalassemia has been achieved through high level globin lentiviral vector gene transfer into mouse hematopoietic stem cells (HSCs). However, transduction of human HSCs is less robust and may be inadequate to achieve therapeutic levels of genetically modified erythroid cells. We therefore developed a double gene lentiviral vector encoding both human 
-globin under the transcriptional control of erythroid regulatory elements and methylguanine methyltransferase (MGMT), driven by a constitutive cellular promoter. MGMT expression provides cellular resistance to alkylator drugs, which can be administered to kill residual untransduced, diseased HSCs, while transduced cells are protected. Mice transplanted with -thalassemic HSCs transduced with a -globin/MGMT vector initially had subtherapeutic levels of red cells expressing -globin. To enrich -globin-expressing cells, transplanted mice were treated with the alkylator agent, 1,3-bis-chloroethyl-1-nitrosourea (BCNU). This resulted in significant increases in the number of -globin-expressing red cells and the amount of fetal hemoglobin, leading to resolution of anemia. Selection of transduced HSCs was also obtained when cells were drug-treated prior to transplantation. Mice that received these cells demonstrated reconstitution with therapeutic levels of -globin expressing cells. These data suggest that MGMT-based drug-selection holds promise as a modality to improve gene therapy for -thalassemia.
