Wiskott-Aldrich Syndrome (WAS) is a rare X-linked primary immunodeficiency affecting approximately 1 in 100,000 live XY births in North America and is caused by a mutation to the WAS gene which is expressed across hematopoietic lineages. The WAS protein (WASp) plays a role in regulating actin polymerization. On a cellular level, there are a variety of effects of a lack of WASp or expression of a dysfunctional WASp protein for patients including issues with migration, adhesion, chemotactic response, phagocytosis, activation, and proliferation across different cell types in addition to reduced platelet size and output. This can lead to several systematic effects for the patients however because mutations to the WAS gene are not limited to one location or type there is a great amount of variability between patient symptoms making it challenging to diagnose. Major symptoms include frequent and recurrent infections, uncontrolled bleeding episodes, issues associated with autoimmunity, and malignancy, the most common form being lymphoma. Without treatment, the life expectancy of an individual diagnosed with WAS is 14 years of age, and the only curative treatment strategy available is hematopoietic stem and progenitor cell transfer (HSPCT). If not performed with an HLA-identical donor, which is available to less than 10% of patients, and within the first two years of life, the risk of graft versus host disease (GvHD) increases drastically for the patient. A gene therapy using autologous and genetically corrected CD34+ cells would be advantageous to the patients due to a reduction in preparative conditioning, immunosuppressive aftercare, and the risk of GvHD. CSL Behring is currently in the development of a lentiviral gene therapy to fulfill this gap in care, however, to develop the assays required to assess and characterize the drug substance usually an uncorrected patient sample is compared with a gene-edited sample. The limitation here is that due to the risk of infection and bleeding patient sample is very limited and therefore the development of a mock patient sample is necessary for early development. The goal of the project is to develop a WAS-KO protocol utilizing CRISPR/Cas9 and its characterization.

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O transplante de células tronco hematopoéticas alogênico e autogênico na leucemia mielóide aguda em primeira remissão completa: analise de 62 pacientes. Os pacientes foram submetidos a transplante de células tronco hematopoéticas alogênico e autogênico. Ao final do estudo estavam vivos no alogênico 43,3% e no autogênico 62,5%. Consolidação intensiva teve melhor sobrevida no alogênico. Os pacientes com DECH aguda grau II tiveram melhor sobrevida. Dois pacientes com DECH crônica extensa morreram. Óbito por infecção ocorreu com maior freqüência no alogênico seguido de recidiva. No autogênico a recidiva foi a principal causa de óbito. Morte por toxicidade ocorreu em 47% dos pacientes que foram a óbito no alogênico e em 8,3% no autogênico. Na analise múltipla de Cox a consolidação intensiva e DECH crônica, tiveram significância. / The allogeneic and autologous hematopoietic stem cell transplantation in acute myeloid leukemia in first complete remission: analyses of 62 patients. The patients were submitted to allogeneic and autologous hematopoietic stem cell transplantation. The end of the study were kept alive in allogeneic 43,3% and in autologous 65,2%. Patient in allogeneic who were consolidated had better survival. Patients with acute GVHD grade II had better survival. Two patients with chronic GVHD in intense, died. Infection was the most frequent dead cause in allogeneic following relapse. In autologous the relapse was the principal cause of death. Toxicity occurred in 47% of patients who died in allogeneic and 8,3% in autologous. In cox multiple analyses intensive consolidation and chronic GVHD had significance.

O transplante de células tronco hematopoéticas alogênico e autogênico na leucemia mielóide aguda em primeira remissão completa: analise de 62 pacientes. Os pacientes foram submetidos a transplante de células tronco hematopoéticas alogênico e autogênico. Ao final do estudo estavam vivos no alogênico 43,3% e no autogênico 62,5%. Consolidação intensiva teve melhor sobrevida no alogênico. Os pacientes com DECH aguda grau II tiveram melhor sobrevida. Dois pacientes com DECH crônica extensa morreram. Óbito por infecção ocorreu com maior freqüência no alogênico seguido de recidiva. No autogênico a recidiva foi a principal causa de óbito. Morte por toxicidade ocorreu em 47% dos pacientes que foram a óbito no alogênico e em 8,3% no autogênico. Na analise múltipla de Cox a consolidação intensiva e DECH crônica, tiveram significância. / The allogeneic and autologous hematopoietic stem cell transplantation in acute myeloid leukemia in first complete remission: analyses of 62 patients. The patients were submitted to allogeneic and autologous hematopoietic stem cell transplantation. The end of the study were kept alive in allogeneic 43,3% and in autologous 65,2%. Patient in allogeneic who were consolidated had better survival. Patients with acute GVHD grade II had better survival. Two patients with chronic GVHD in intense, died. Infection was the most frequent dead cause in allogeneic following relapse. In autologous the relapse was the principal cause of death. Toxicity occurred in 47% of patients who died in allogeneic and 8,3% in autologous. In cox multiple analyses intensive consolidation and chronic GVHD had significance.