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Anemia, Sickle CellPhase 1/2NCT02186418

Gene Transfer for Patients With Sickle Cell Disease

A Phase 1/2 study testing ARU-1801 in people with Anemia, Sickle Cell, run by Children's Hospital Medical Center, Cincinnati at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this Phase 1/2 study is to determine the feasibility and safety of stem cell collection and gamma-globin gene transfer, and success of gene correction in subjects with sickle cell disease Read more about this study

Who is it for?
Ages 18 to 45 years
Conditions the study is for
Anemia, Sickle Cell
What is being tested?
ARU-1801
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
7 participants
Where
1 siteUnited States
Study dates
Jul 2014to 31 Oct 2022
Phase
Phase 1/2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Signed informed consent form.
  • Has confirmed diagnosis of sickle cell disease (SCD)
  • Has severe sickle cell disease, defined as one or more of the following:
  • Minimum of two episodes of clinically diagnosed acute chest syndrome (ACS) requiring hospital admission, or one life threatening episode of ACS requiring intensive care unit (ICU) admission for exchange transfusion and/or intubation, or frequent ACS episodes which necessitate treatment with chronic transfusion therapy.
  • Frequent painful vaso-occlusive episodes (VOEs) which significantly interfere with normal life activities, defined as a history of 2 or more severe acute sickle pain events per year requiring additional treatment at a medical facility outside of home pain management over the preceding 2-year period prior to study enrollment, or that necessitate chronic transfusion therapy.
  • Subjects on chronic transfusion therapy for severe disease symptoms other than those listed above, and which interfere with normal life activities.
  • Has failed hydroxyurea therapy, was unable to tolerate hydroxyurea therapy, or has actively made the choice to not take the recommended daily hydroxyurea advised for severe disease (Note: must be off hydroxyurea therapy for 2 months prior to stem cell collection). If refusing hydroxyurea, the subject must document that they have been educated about the benefits and continue to refuse the treatment. Patients placed on chronic transfusion therapy instead of hydroxyurea for severe disease are eligible. Subjects unable to take hydroxyurea due to financial or safety monitoring constraints are eligible.
  • Has adequate functional status and organ function as determined at Screening.

Who cannot join

  • Female subjects who are pregnant or lactating/breastfeeding.
  • Female subjects who are not surgically sterile, postmenopausal or who refuse to practice effective method of birth control as determined by the Investigator for one year after receiving the study drug. Women must also agree not to breastfeed for 1 year after receiving the study drug.
  • Any participant of reproductive potential who refuses to agree to use an appropriate contraceptive method determined by the Investigator, for 1 year after receiving the study drug.
  • Patients with an active malignant disease or receiving treatment for any type of cancer (except squamous cell carcinoma, basal cell carcinoma, or carcinoma in situ of the skin).
  • Current diagnosis or history of hepatitis B, hepatitis C, or HIV.
  • Has received another study drug within 30 days, or 5 half-lives of the last dose (whichever is longer), prior to screening.
Show all 14Show fewer
  • Has severe obstruction, restriction or diffusion defect on pulmonary function tests.
  • Has uncontrolled bacterial, viral or fungal infections within 1 month prior to starting the conditioning part of the study. Subjects with fever should wait for symptoms to resolve before starting the conditioning part of the study.
  • Has a history of stroke or is at moderate to high risk of primary stroke (eg receiving chronic transfusions or hydroxyurea for primary prevention of stroke; has severe cerebral vasculopathy defined as moderate stenosis in >2 arterial segments; and/or has sever stenosis/occlusion in ≤2 segments in the polygon of Willis or presence of Moyamoya-like disease).
  • Patients with alpha thalassemia sickle cell disease.
  • Has previous liver biopsy showing cirrhosis, bridging hepatic fibrosis, or active hepatitis; or has received chronic transfusions and has previous evidence of iron overload and evidence of liver fibrosis by noninvasive liver imaging.
  • Has a matched sibling donor, unless the subject has declined this option or this option is not feasible. Documentation must be included as part of the informed consent process for subjects who decline this option.
  • Has a known hypersensitivity to any study treatments (e.g. melphalan, plerixafor).
  • Other protocol-defined inclusion-exclusion criteria may apply.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

Other trials in United States

About this study

Official title: Gene Transfer For Patients With Sickle Cell Disease Using A Gamma Globin Lentivirus Vector: An Open-Label Phase 1 / 2 Pilot Study

The purpose of this Phase 1/2 study is to determine the feasibility and safety of stem cell collection and gamma-globin gene transfer, and success of gene correction in subjects with sickle cell disease

Read the detailed description

This study will assess the feasibility, safety and efficacy of gene transfer using ARU-1801 (CD34+ cells transduced with the gamma-globin lentiviral vector). Gene transfer will occur ex-vivo into CD34+ enriched human bone marrow or plerixafor-mobilized peripheral blood hematopoietic stem cells (HSC) collected from subjects with severe sickle cell disease (SCD). Subjects will undergo reduced intensity chemotherapy conditioning with single-dose melphalan to facilitate engraftment of ex-vivo ARU-1801 via IV infusion. Subjects will return to the study site at regular intervals for follow-up for 2 years after the ARU-1801 infusion. It is anticipated that a separate long-term follow-up (LTFU) clinical study will be initiated, in which all subjects completing the 2 year study visit will be asked to consent and enroll, and will followed for a further 13 years.

Being tested
ARU-1801
Keywords
sickle cell disease, sickle cell anemia, hemoglobinopathies, hematopoietic stem cell, gene transfer, gene therapy
Medical subject headings
Anemia, Sickle Cell, Hemoglobinopathies

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ARU-1801Genetic

    Autologous CD34+ hematopoietic stem cells transduced ex-vivo with a gamma-globin lentiviral vector

    • Subjects with sickle cell anemia will undergo hematopoietic stem cell procurement by bone marrow harvest or apheresis after mobilization with plerixafor
    • Reduced intensity chemotherapy conditioning with single dose melphalan will be used to facilitate engraftment of ex-vivo transduced cells.
Study groups in NCT02186418
Study groupRoleWhat they receive
ARU-1801ExperimentalAutologous CD34+ hematopoietic stem cells transduced ex-vivo with gamma-globin lentiviral vector. Administered via IV infusion.
Receives: Genetic: ARU-1801

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of Grade 3 allergic reaction

    Incidence of Grade 3 allergic reaction associated with infusion of transduced cell product

    Measured: From infusion (Day 0) to 15 years

  2. Incidence of Grade 4 infection

    Incidence of Grade 4 infection following infusion of transduced cell product uncontrolled for ≥14 days

    Measured: From infusion (Day 0) to 15 years

  3. Incidence of Grade 4 neutropenia

    Incidence of Grade 4 neutropenia lasting >1 month following melphalan

    Measured: From date of chemotherapy clearance visit to 15 years post-infusion of transduced cells

  4. Incidence of Grade 3 or 4 organ toxicity

    Incidence of Grade 3 or 4 organ toxicity attributable to study procedures

    Measured: From screening to 15 years post-infusion of transduced cells

  5. Incidence of Adverse Events (AEs)

    Measured: From screening to 15 years post-infusion of transduced cells

  6. Incidence of Serious Adverse Events (SAEs)

    Measured: From screening to 15 years post-infusion of transduced cells

  7. Incidence of death due to study procedures

    Measured: From screening to 15 years post-infusion of transduced cells

  8. Incidence of hematological malignancy

    Incidence of hematological malignancy due to vector insertion

    Measured: From infusion (Day 0) to 15 years

  9. Incidence of hematological cancer

    Incidence of hematological cancer related to investigational product or study medications/procedures

    Measured: From screening to 15 years post-infusion of transduced cells

  10. Time to neutrophil recovery

    Number of days from melphalan-induced nadir to the first of 3 consecutive absolute neutrophil counts ≥500 cells/µL

    Measured: From ≥36 hours before Day 0 to 2 years post-infusion of transduced cells

  11. Time to platelet recovery

    Number of days from melphalan-induced nadir to the first of 3 consecutive platelet counts >50,000 cells/µL and independent of platelet transfusion for ≥7 days consecutive days.

    Measured: From ≥36 hours before Day 0 to 2 years post-infusion of transduced cells

  12. ≥8x10⁶kg viable CD34+ cells

    Number of subjects with a total number of CD34+ cells recovered from all collections combined (mobilized peripheral blood and bone marrow) of at least ≥8x10⁶kg viable CD34+ cells

    Measured: Up to Year 2

  13. ≥4x10⁶ CD34+ cells/kg body weight transduced

    Proportion of subjects for which a minimum of 4x10⁵ CD34+ cells/kg body weight from all collections combined have been successfully transduced

    Measured: Up to Year 2

  14. Bone marrow aspirates with ≥1% gene-marked cells

    Number of subjects with bone marrow aspirates at 1-year post-infusion with ≥1% gene-marked cells

    Measured: Infusion (Day 0) to 1 year

Secondary outcomes (10)
  1. Quantity of Hb (hemoglobin) subtypes

    Quantification of HbF^G16D and other Hb subtypes, including HbF (endogenous), HbS, adult Hb (HbA), HbA2 and, if applicable, HbC and HbE

    Measured: Months 6, 12, 18, 24 and year 3, 4, 5

  2. Change in proportion of antisickling/sickling hemoglobin

    Change in the proportion of antisickling/sickling hemoglobin ([HbF+HbF^G16D+HbA2]/HbS) in months 6-12 post-transplantation compared to baseline

    Measured: Baseline to Month 6 through 12

  3. Percentage of F-RBC (fetal hemoglobin content in red blood cells)

    Measured by flow cytometry

    Measured: Months 6, 12, 18, 24, 36

  4. Percentage of F-retics (fetal hemoglobin content in reticulocytes)

    Measured by flow cytometry

    Measured: Months 6, 12, 18, 24, 36

  5. Presence of vector copies in white blood cell fraction

    Measured: Days 30, 60, 90, Months 4, 5, 6, 9, 12, 18, 21, 24

  6. Presence of vector copies in bone marrow

    Measured by qPCR and DNA

    Measured: Prior to ARU-1801 infusion, month 6, 12, 18, 24 and 36

  7. Presence of gene-marked colony-forming unit cells (CFU-c) in bone marrow (BM) indicting gene transfer

    Measured by CFU-c assay by qPCR on individual CFU-c

    Measured: Prior to ARU-1801 infusion, month 6, 12, 18, 24 and 36

  8. Number of annualized vaso-occlusive episodes (VOEs) pre-transplant versus post-transplant

    Change in disease severity

    Measured: Baseline to year 15

  9. Frequency of opioid use pre-transplant versus post-transplant

    Change in disease severity

    Measured: Baseline to year 15

  10. Change in QoL (Quality of Life)

    Measured by adult sickle cell quality of life measurement (ASCQ-Me®)

    Measured: Baseline, month 4, 5, 6, 12 and 24 and year 3, 4, 5

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Jul 2014 (estimated)
  2. Study startJul 2014
  3. Primary completion31 Oct 2022
  4. Study completion31 Oct 2022

Why it stopped: Sponsor decision due to funding

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Supportive care
Allocation
Not applicable
Intervention model
Single group
Model description
Gamma Globin Lentivirus Vector
Masking
None (open label)
Enrolment
7 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02186418
Sponsor's protocol ID
ARU-1801_Ph1_01
Status last verified
Jul 2023
First submitted
30 Jun 2014
Last updated
12 Apr 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Grimley M, Davies SM, Shrestha A, Shova A, Asnani M, Kent M, Sayani F, Quinn CT, Niss O, Lutzko C, Mehta PA, Khandelwal P, Little C, Chandra S, Felker S, Chi M, Kalfa TA, Knight-Madden J, Arumugam PI, Ramos KN, Witting S, Latham T, Bushman FD, Malik P. Lentiviral gene therapy with reduced-intensity conditioning for sickle cell disease: a phase 1/2 trial. Nat Med. 2025 Jul;31(7):2204-2212. doi: 10.1038/s41591-025-03662-2. Epub 2025 May 26.

    PubMed 40419809

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing ARU-1801 in people with Anemia, Sickle Cell, run by Children's Hospital Medical Center, Cincinnati at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 12 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: Sponsor decision due to funding). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of Grade 3 allergic reaction (time frame: From infusion (Day 0) to 15 years). The study lists 14 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02186418, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Apr 2024.

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