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Mucopolysaccharidosis IHPhase 1/2TigetT10_MPSIHNCT03488394

Gene Therapy With Modified Autologous Hematopoietic Stem Cells for the Treatment of Patients With Mucopolysaccharidosis Type I, Hurler Variant

A Phase 1/2 study testing Frozen autologous CD34+ hematopoietic stem and progenitor cells genetically modified with the lentiviral vector IDUA LVV, encoding for the α-L-iduronidase cDNA, in their final formulation medium. in people with Mucopolysaccharidosis IH, run by Orchard Therapeutics at 1 site in Italy.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This is a phase I/II study evaluating safety and efficacy of autologous hematopoietic stem and progenitor cells genetically modified with IDUA lentiviral vector encoding for the human α-L-iduronidase gene for the treatment of patients affected by Mucopolysaccharidosis Type I, Hurler variant Read more about this study

Who is it for?
Ages 28 days to 11 years
Conditions the study is for
Mucopolysaccharidosis IH
What is being tested?
Frozen autologous CD34+ hematopoietic stem and progenitor cells genetically modified with the lentiviral vector IDUA LVV, encoding for the α-L-iduronidase cDNA, in their final formulation medium.
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
8 participants
Where
1 siteItaly
Study dates
11 May 2018to Mar 2035
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

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 28 days to 11 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Written informed consent by parent/legal guardian
  • Sex: Males and Females
  • Age: ≥ 28 days and ≤ 11 years old
  • Biochemically and molecularly proven MPS IH
  • Lansky index >80%
  • Indication to hematopoietic stem cell transplant
  • Lack of a non-heterozygous (for mutated IDUA) HLA-matched sibling donor or a ≥7/8 (4 digits high-resolution typing) HLA-matched cord blood donor with a cellularity ≥5 x 10^7 Total Nucleated Cells (TNC)/Kg after 1-month search.(This criterion will not apply to patients whose country of origin does not offer unrelated donor cord blood transplantation).
  • Adequate cardiac, renal, hepatic and pulmonary functions

Who cannot join

  • Use of other investigational agents within 4 weeks prior to study enrolment (within 6 weeks if use of long-acting agents)
  • Severe, active viral, bacterial or fungal infection at eligibility evaluation
  • Patients affected by neoplasia or family history of familial cancer syndromes
  • Cytogenetic alterations associated with high risk of developing hematological malignancies
  • History of uncontrolled seizures
  • Patients with end-organ damage or any other severe disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study
Show all 10Show fewer
  • Positivity for HIV (serology or RNA), and/or HbsAg and/or HBV DNA and/or HCV RNA and/or Treponema Pallidum or Mycoplasma active infection
  • Patients with DQ/IQ <70
  • Previous allogeneic hematopoietic stem cells transplantation or gene therapy with a different product
  • Contraindications to PeIMP (G-CSF, Plerixafor, Busulfan, Fludarabine, Rituximab)

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • Ospedale San Raffaele

    Milan, 20132

Other trials in Italy

About this study

Official title: Phase I/II Study Evaluating Safety and Efficacy of Autologous Hematopoietic Stem and Progenitor Cells Genetically Modified With IDUA Lentiviral Vector Encoding for the Human α-L-iduronidase Gene for the Treatment of Patients Affected by Mucopolysaccharidosis Type I, Hurler Variant

This is a phase I/II study evaluating safety and efficacy of autologous hematopoietic stem and progenitor cells genetically modified with IDUA lentiviral vector encoding for the human α-L-iduronidase gene for the treatment of patients affected by Mucopolysaccharidosis Type I, Hurler variant

Read the detailed description

Pediatric patients with mucopolysaccharidosis type I will be treated with genetically modified autologous hematopoietic stem cells collected from mobilized peripheral blood (or bone marrow if mobilization is not feasible) and transduced with IDUA lentiviral vector encoding for the human α-L-iduronidase gene.

Participants will be followed for up to 15 years post treatment (per regulatory guidelines for follow up of patients treated with ATMPs, under this study (TigetT10_MPSIH) or via enrollment into a separate long term follow-up (LTFU) study for the overall OTL-203 Clinical Development Program, if one is set up prior to their Year 15 visit.

Being tested
Frozen autologous CD34+ hematopoietic stem and progenitor cells genetically modified with the lentiviral vector IDUA LVV, encoding for the α-L-iduronidase cDNA, in their final formulation medium.
Keywords
Mucopolysaccharidosis IH, Gene Therapy, Transplantation, Autologous, Lentiviral vector
Medical subject headings
Mucopolysaccharidosis I

What participants receive

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

  • Frozen autologous CD34+ hematopoietic stem and progenitor cells genetically modified with the lentiviral vector IDUA LVV, encoding for the α-L-iduronidase cDNA, in their final formulation medium.Genetic

    The drug product target dose is more or equal to 8x10^6 CD34+ cells/Kg, with a minimum dose of 4x10^6 CD34+ cells/Kg and a maximum dose of 35x10^6 CD34+ cells/Kg.

    The product will be injected intravenously.

Study groups in NCT03488394
Study groupRoleWhat they receive
TreatmentExperimentalGene therapy (autologous, CD34+ cell enriched cells fraction containing HSPCs, transduced with the IDUA LVV encoding for the human IDUA gene and cryopreserved in cryoformulation medium)
Receives: Genetic: Frozen autologous CD34+ hematopoietic stem and progenitor cells genetically modified with the lentiviral vector IDUA LVV, encoding for the α-L-iduronidase cDNA, in their final formulation medium.

What is being measured

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

  1. Overall survival

    Number and percentage of subjects alive at the end of the trial

    Measured: Assessed at multiple timepoints up to 15 years post-treatment

  2. Achievement of haematological engraftment

    Percentage of subjects with both neutrophil count more than 500/mm3 and platelets more than 20,000/mm3 (in the absence of platelet transfusion for seven consecutive days) on 3 consecutive blood counts in the first 45 days from ATIMP injection.

    Measured: within day +45 after gene therapy

  3. Safety of the administration of autologous haematopoietic stem cells transduced with IDUA LVV - Short term tolerability

    Percentage of subjects not experiencing short-term adverse events of any grade and systemic reactions

    Measured: 0-24 hours from ATIMP injection

  4. Safety of the administration of autologous haematopoietic stem cells transduced with IDUA LVV - Absence of Replication Competent Lentivirus

    Percentage of subjects without Replication Competent Lentivirus

    Measured: Assessed at multiple timepoints up to 8 years post-treatment, or if clinically indicated

  5. Safety of the administration of autologous haematopoietic stem cells transduced with IDUA LVV - Absence of malignancy or abnormal clonal proliferation

    Percentage of subjects without abnormal clonal proliferation

    Measured: Assessed at multiple timepoints up to 15 years post-treatment

  6. Overall safety and tolerability (AE)

    The number of AEs (expected/unexpected and/or related/not related) and SAEs (expected/unexpected and/or related/not related) and the percentage of subjects experiencing AEs (expected/unexpected and/or related/not related) and SAEs (expected/unexpected and/or related/not related) will be summarized by severity and within body system involved. Narratives will also be presented. The rate of occurrence of these events will also be estimated.

    Measured: Assessed at multiple timepoints up to 15 years post-treatment

  7. IDUA activity in blood (up to supraphysiologic levels) at 1-year post-treatment

    IDUA activity measured on peripheral dried blood spot

    Measured: At 1 year post-treatment

Secondary outcomes (7)
  1. Anti-IDUA antibody immune response

    Presence or absence and titer of anti-IDUA antibody on plasma or serum

    Measured: Assessed at multiple timepoints up to 8 years post-treatment, or if clinically indicated

  2. Achievement of supraphysiologic IDUA activity in blood

    IDUA activity measured on peripheral dried blood spots up to supraphysiologic levels as compared with healthy donors. A supraphysiologic IDUA level is defined as >24.31 μmol/L/h, which is the 97.5th percentile of the IDUA distribution in healthy children

    Measured: Assessed at multiple timepoints up to 15 years post-treatment

  3. IDUA activity in plasma

    IDUA activity measured on plasma samples from peripheral blood.

    Measured: Assessed at multiple timepoints up to 15 years post-treatment

  4. Engraftment of transduced cells ≥ 0.30 VCN/genome

    Percentage of subjects with engraftment of transduced cells ≥ 0.30 VCN/genome on peripheral blood mononuclear cells (PBMC) and/or bone marrow (BM) progenitor cells.

    Measured: Assessed at multiple timepoints up to 15 years post-treatment

  5. Normalization of urinary GAGs

    Percentage of subjects achieving normalization of urinary GAG levels (heparan sulfate and dermatan sulfate) measured by HPLC

    Measured: Assessed at multiple timepoints up to 15 years post-treatment

  6. Normalization of spleen and liver

    Percentage of subjects with normal spleen and liver assessed by clinical examination (palpation) and/or ultrasound

    Measured: Assessed at multiple timepoints up to 15 years post-treatment

  7. Growth velocity

    Length/height for age (cm) per month vs. WHO percentiles

    Measured: Assessed at multiple timepoints up to 15 years post-treatment

Timeline

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

  1. First posted5 Apr 2018
  2. Study start11 May 2018
  3. Primary completionJan 2035 (estimated)
  4. Study completionMar 2035 (estimated)

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
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
8 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03488394
Sponsor's protocol ID
2024-514870-29-00
Acronym
TigetT10_MPSIH
Status last verified
Jul 2026
First submitted
22 Mar 2018
Last updated
16 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Consiglieri G, Tucci F, De Pellegrin M, Guerrini B, Cattoni A, Risca G, Scarparo S, Sarzana M, Pontesilli S, Mellone R, Gasperini S, Galimberti S, Silvani P, Filisetti C, Darin S, Forni G, Miglietta S, Santi L, Facchini M, Corti A, Fumagalli F, Cicalese MP, Calbi V, Migliavacca M, Barzaghi F, Ferrua F, Gallo V, Recupero S, Canarutto D, Doglio M, Tedesco L, Volpi N, Rovelli A, la Marca G, Valsecchi MG, Zancan S, Ciceri F, Naldini L, Baldoli C, Parini R, Gentner B, Aiuti A, Bernardo ME. Early skeletal outcomes after hematopoietic stem and progenitor cell gene therapy for Hurler syndrome. Sci Transl Med. 2024 May;16(745):eadi8214. doi: 10.1126/scitranslmed.adi8214. Epub 2024 May 1.

    PubMed 38691622
  • Gentner B, Tucci F, Galimberti S, Fumagalli F, De Pellegrin M, Silvani P, Camesasca C, Pontesilli S, Darin S, Ciotti F, Sarzana M, Consiglieri G, Filisetti C, Forni G, Passerini L, Tomasoni D, Cesana D, Calabria A, Spinozzi G, Cicalese MP, Calbi V, Migliavacca M, Barzaghi F, Ferrua F, Gallo V, Miglietta S, Zonari E, Cheruku PS, Forni C, Facchini M, Corti A, Gabaldo M, Zancan S, Gasperini S, Rovelli A, Boelens JJ, Jones SA, Wynn R, Baldoli C, Montini E, Gregori S, Ciceri F, Valsecchi MG, la Marca G, Parini R, Naldini L, Aiuti A, Bernardo ME; MPSI Study Group. Hematopoietic Stem- and Progenitor-Cell Gene Therapy for Hurler Syndrome. N Engl J Med. 2021 Nov 18;385(21):1929-1940. doi: 10.1056/NEJMoa2106596.

    PubMed 34788506
  • Tucci F, Uria Oficialdegui ML, Consiglieri G, Cossutta M, Filisetti C, Fumagalli F, Butera C, Santangelo R, Colombo M, Manitto MP, Stoppani M, Martina E, Dane G, Camesasca C, Risca G, De Pellegrin M, Scarparo S, Sarzana M, Puricelli C, Galimberti S, Darin S, Silvani P, Bonanomi S, Gasperini S, Naldini L, Gentner B, Parini R, Del Toro M, Diaz-de-Heredia C, Aiuti A, Bernardo ME. Non-neurological, non-skeletal outcomes after hematopoietic stem and progenitor cell-gene therapy (OTL-203) for Hurler syndrome. Mol Ther. 2026 Jan 7;34(1):443-454. doi: 10.1016/j.ymthe.2025.09.042. Epub 2025 Sep 27.

    PubMed 41017152

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Frozen autologous CD34+ hematopoietic stem and progenitor cells genetically modified with the lentiviral vector IDUA LVV, encoding for the α-L-iduronidase cDNA, in their final formulation medium. in people with Mucopolysaccharidosis IH, run by Orchard Therapeutics at 1 site in Italy.

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 10 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: under way, not looking for participants, as of the sponsor's last update on 16 Jul 2026. 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 Italy. 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?

This study is still under way. Results are not available in the source record yet.

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?

Overall survival (time frame: Assessed at multiple timepoints up to 15 years post-treatment). The study lists 7 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 NCT03488394, which also lists 3 linked publications.

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 16 Jul 2026.

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