TABLE 4.
SCID Genotype (No. Cases) | SCID Phenotypea | Nursery | TREC Result | Outcome After Treatmentb | |||
---|---|---|---|---|---|---|---|
Urgent Positivec | Positive | Died (Posttransplant d, Cause) | Full T and B Cell Recovery and Off IgG, Treatmentd | T but Not B Cells Reconstituted, Still on IgG, Treatment | |||
IL2RG (14) | Typical | Regular | 12 | 0 | 1 (218 d, SOSe, CMV) | 2 cond MUD, 1 GT, 1 cond MUD after GT | 6 MMRD, 1 cond MUDf, 1 GT, 1 GT after MMRD |
NICU | 2 | 0 | |||||
ADA (9) | Typical | Regular | 5 | 2 | 0 | 8 GT, 1 MSD | 0 |
NICU | 1 | 0 | |||||
Leaky | Regular | 0 | 1 | ||||
RAG1 (8) | Typical | Regular | 2 | 0 | 1 (28 d, SOS) | 1 cond MSD | 0 |
Leaky | Regular | 2 leaky, 1 Omenn syndrome | 1 leaky, 2 Omenn syndrome | 0 | 4 cond MMRD | 2 cond MMRD (1 of whom planning to stop IgG) | |
IL7R (6) | Typical | Regular | 5 | 0 | 0 | 4 MMRD, 1 MUD, 1 cond MSD after MSD | 0 |
Typical | NICU | 0 | 1 | ||||
JAK3 (3) | Typical | Regular | 3 | 0 | 0 | 1 cond MSD, 1 cond MUD | 1 MMRD |
RAG2 (3) | Typical | Regular | 2 | 0 | 0 | 1 MSD, 2 cond MUD | 0 |
Leaky | Regular | 0 | 1 | ||||
BCL11B (1) | Leaky | Regular | 1 | 0 | 0 | 1 cond MUD | 0 |
RMRP (1) | Leaky | Regular | 0 | 1 | 0 | 1 cond MUD | 0 |
Unknown (4) | Typical | Regular | 1 | 1 | 1 (69 d, CMV) | 0 | 1 cond MUD planning to stop IgG |
NICU | 1 | 0 | 0 | 0 | 1 Cond MUD | ||
Leaky | Regular | 1 | 0 | 0 | 0 | 1 cond MUD planning to stop IgG |
Cond, conditioning with busulfan chemotherapy and, in some instances, fludarabine or other agents; MMRD, mismatched related donor; MSD, matched sibling donor; MUD, matched adult or cord blood unrelated donor.
Criteria from the PIDTC for typical SCID and leaky SCID; Omenn syndrome, a subset of leaky SCID, includes erythroderma rash, adenopathy, oligoclonal T-cell expansion, eosinophilia, and elevated immunoglobin E levels.
One infant not included in this table had urgent-positive TRECs and the T−B−NK+ SCID lymphocyte profile but left the United States before HCT; no genotype or follow-up is available.
Three or fewer TREC copies with a normal control polymerase chain reaction copy number by the EnLite kit assay or equivalent with a previous in-laboratory assay.
Treatments included GT with low-dose busulfan followed by autologous CD34+ bone marrow cells transduced with a correct copy of the mutated gene (IL2RG or ADA), MMRD (usually a parent who is haploidentical), MSD, MUD. Cond, conditioning with busulfan chemotherapy and (in some instances) fludarabine or other agents (other infants may have had serotherapy with rabbit antithymocyte globulin or anti-CD52).
Posttransplant hepatic sinusoidal obstruction syndrome after busulfan chemotherapy.
One patient left the United States after conditioned MUD HCT and reconstitution; it is not known if the patient is still on IgG.