Pilocytic Astrocytoma in a Child with Spinal Muscular Atrophy Treated with Onasemnogene Abeparvovec.

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Tác giả: Iulian Alecu, Antonella Lucía Bastone, Hildegard Büning, Gabriele Calaminus, Valerie Dubost, Johannes Friese, Dorothea Holzwarth, Philipp John-Neek, Janbernd Kirschner, Brent Kuzmiski, Ivan Labik, Silvana Libertini, Keith Mansfield, Michael Rothe, Thomas Sejersen

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: United States : Molecular therapy : the journal of the American Society of Gene Therapy , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 148669

Spinal muscular atrophy (SMA) is a severe neuromuscular disease, leading to progressive muscle weakness and potentially early mortality if untreated. Onasemnogene abeparvovec is a recombinant adeno-associated virus serotype 9 (rAAV9)-based gene therapy that has demonstrated improvements in survival and motor function for SMA patients. Here, we present a case of a patient diagnosed with a grade 1 pilocytic astrocytoma at the age of 2 years, approximately 8 months after onasemnogene abeparvovec treatment. Although vector genomes delivered by rAAVs persist primarily as episomes, rare integration events have been linked to tumor formation in neonate murine models. Therefore, we investigated the presence and possible integration of onasemnogene abeparvovec in formalin-fixed paraffin embedded (FFPE) and frozen tumor samples. In situ hybridization demonstrated variable transduction levels in individual tumor cells while droplet digital PCR measured an average vector copy number ranging from 0.7-4.9 vector genomes/diploid genome. Integration site analysis identified a low number of integration sites that were not conserved between technical replicates, nor between FFPE and frozen samples, indicating that cells hosting integrating vector genomes represent a minority in the overall cell population. Thus, molecular analysis of the tumor tissue suggests that tumorigenesis was causally independent of the administration of onasemnogene abeparvovec.
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