TY - JOUR AU - Liu, Yang AU - Dahl, Maria AU - Debnath, Shubhranshu AU - Rothe, Michael AU - Smith, Emma M. AU - Grahn, Tan Hooi Min AU - Warsi, Sarah AU - Chen, Jun AU - Flygare, Johan AU - Schambach, Axel AU - Karlsson, Stefan PY - 2022/02/01 Y2 - 2024/03/29 TI - Successful gene therapy of Diamond-Blackfan anemia in a mouse model and human CD34<sup>+</sup> cord blood hematopoietic stem cells using a clinically applicable lentiviral vector JF - Haematologica JA - haematol VL - 107 IS - 2 SE - Articles DO - 10.3324/haematol.2020.269142 UR - https://haematologica.org/article/view/haematol.2020.269142 SP - 446-456 AB - Diamond-Blackfan anemia (DBA) is an inherited bone marrow failure disorder in which pure red blood cell aplasia is associated with physical malformations and a predisposition to cancer. Twentyfive percent of patients with DBA have mutations in a gene encoding ribosomal protein S19 (RPS19). Our previous proof-of-concept studies demonstrated that DBA phenotype could be successfully treated using lentiviral vectors in Rps19-deficient DBA mice. In our present study, we developed a clinically applicable single gene, self-inactivating lentiviral vector, containing the human RPS19 cDNA driven by the human elongation factor 1a short promoter, which can be used for clinical gene therapy development for RPS19-deficient DBA. We examined the efficacy and safety of the vector in a Rps19-deficient DBA mouse model and in human primary RPS19-deficient CD34+ cord blood cells. We observed that transduced Rps19-deficient bone marrow cells could reconstitute mice long-term and rescue the bone marrow failure and severe anemia observed in Rps19-deficient mice, with a low risk of mutagenesis and a highly polyclonal insertion site pattern. More importantly, the vector can also rescue impaired erythroid differentiation in human primary RPS19-deficient CD34+ cord blood hematopoietic stem cells. Collectively, our results demonstrate the efficacy and safety of using a clinically applicable lentiviral vector for the successful treatment of Rps19-deficient DBA in a mouse model and in human primary CD34+ cord blood cells. These findings show that this vector can be used to develop clinical gene therapy for RPS19-deficient DBA patients. ER -