Correction of X-linked chronic granulomatous disease by gene therapy, augmented by insertional activation of MDS1-EVI1, PRDM16 or SETBP1

Nat Med. 2006 Apr;12(4):401-9. doi: 10.1038/nm1393. Epub 2006 Apr 2.


Gene transfer into hematopoietic stem cells has been used successfully for correcting lymphoid but not myeloid immunodeficiencies. Here we report on two adults who received gene therapy after nonmyeloablative bone marrow conditioning for the treatment of X-linked chronic granulomatous disease (X-CGD), a primary immunodeficiency caused by a defect in the oxidative antimicrobial activity of phagocytes resulting from mutations in gp91(phox). We detected substantial gene transfer in both individuals' neutrophils that lead to a large number of functionally corrected phagocytes and notable clinical improvement. Large-scale retroviral integration site-distribution analysis showed activating insertions in MDS1-EVI1, PRDM16 or SETBP1 that had influenced regulation of long-term hematopoiesis by expanding gene-corrected myelopoiesis three- to four-fold in both individuals. Although insertional influences have probably reinforced the therapeutic efficacy in this trial, our results suggest that gene therapy in combination with bone marrow conditioning can be successfully used to treat inherited diseases affecting the myeloid compartment such as CGD.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carrier Proteins / genetics*
  • Chromosomes, Human, X
  • Clinical Trials as Topic
  • DNA-Binding Proteins / genetics*
  • Gene Transfer Techniques
  • Genetic Linkage
  • Genetic Markers
  • Genetic Therapy / methods*
  • Genetic Vectors
  • Granulomatous Disease, Chronic / blood
  • Granulomatous Disease, Chronic / etiology
  • Granulomatous Disease, Chronic / genetics
  • Granulomatous Disease, Chronic / therapy*
  • Hematopoietic Stem Cells / physiology*
  • Humans
  • MDS1 and EVI1 Complex Locus Protein
  • Mutagenesis, Insertional
  • Neoplasm Proteins / genetics*
  • Neutrophils / physiology
  • Nuclear Proteins / genetics*
  • Proto-Oncogenes
  • RNA, Messenger / analysis
  • Retroviridae / genetics
  • Transcription Factors / genetics*
  • Treatment Outcome


  • Carrier Proteins
  • DNA-Binding Proteins
  • Genetic Markers
  • MDS1 and EVI1 Complex Locus Protein
  • MECOM protein, human
  • Neoplasm Proteins
  • Nuclear Proteins
  • PRDM16 protein, human
  • RNA, Messenger
  • SETBP1 protein, human
  • Transcription Factors