ClinicalTrials.gg
Active, not recruitingNCT06364774Updated Oct 29, 2026

ALS20-101 Lentiviral Gene Therapy for Beta Thalassemia

A Phase 1/2 interventional study of ALS20 in Beta-Thalassemia, sponsored by Children's Hospital of Philadelphia. Active, not recruiting at 1 site in United States. Open to participants aged 18 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-10-29.

Sponsored by Children's Hospital of Philadelphia · Phase 1/2, Interventional, and Treatment

Updated Oct 29, 2026Now Active, not recruitingGo to Updates ↓
Phase
Phase 1/2
Study type
Interventional
Enrollment
12
Allocation
Not applicable
Ages
18 Years to 40 Years
Sex
All
01

Study summary

The main goal of this study is to find out if the blood disorder called transfusion-dependent beta thalassemia can be safely treated by modifying blood stem cells. This is done by collecting blood stem cells from the subject, modifying those cells, adding a healthy beta globin gene, and then giving them back to the subject. It is hoped that these modified cells will decrease the need for blood transfusions. The gene modified blood stem cells are called CHOP-ALS20 ("study drug"). This experimental gene therapy has not been tried on human beings before and is not FDA approved.

Read the detailed description

Beta thalassemia major is a hereditary blood disorder that requires lifelong regular transfusions and is associated with significant morbidity, early mortality, and decreased quality of life. Allogeneic hematopoietic stem cell transplantation is potentially curative but limited availability of suitable donors as well as risks of graft versus host disease limit its applicability. Gene addition of a functional beta globin gene may be an alternative treatment option.

The primary objective is to assess the safety of treatment with autologous hematopoietic stem cells transduced with a novel lentiviral vector (ALS20) in subjects 18 to \<36 years old with transfusion dependent beta thalassemia.

The secondary objective is to evaluate the efficacy of treatment with autologous hematopoietic stem cells transduced with a novel lentiviral vector (ALS20) in subjects 18 to \< 36 years old with transfusion dependent beta thalassemia.

Study Design: This is a single arm pilot, phase 1/2 study of up to 12 subjects ages 18 to \<36 years who have transfusion-dependent beta thalassemia (genotypes β0β0, β+β0, β+β+, βEβ0, βEβ+, dominant β thalassemia). The study will evaluate the safety and efficacy of infusing autologous hematopoietic stem and progenitor cells (HSPC) transduced with the novel lentiviral vector ALS20 that encodes the human βA-T87Q-globin, following myeloablative conditioning with busulfan.

The main risks of this study involve risks of the genetic modification of the stem cells and the busulfan chemotherapy conditioning. Genetic modification of blood stem cells may increase the risk of blood cancer. The main risks of busulfan conditioning include prolonged low blood counts, liver injury, infertility, and cancer. There also is a risk of failure of the modified blood stem cells to grow.

02

Conditions studied

  • Beta-Thalassemia

Keywords

  • Thalassemia
  • Beta Thalassemia
  • gene therapy
  • beta globin gene
03

In context

beta-Thalassemia

294 studies on the registry are indexed under beta-Thalassemia; 69 are open to participants now.

This study's planned enrollment of 12 is below the median of 40 across 208 interventional studies indexed under beta-Thalassemia.

Browse beta-Thalassemia studies →

Lead sponsor

Children's Hospital of Philadelphia is the lead sponsor of 489 studies on the registry; 90 are open to participants now.

Of its 28 completed or terminated interventional studies of FDA-regulated products, 22 (79%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Age 18 to \< 40 years at the time of consent
  2. Diagnosis of transfusion dependent beta thalassemia (β0 β0, β+β0, β+β+, βEβ0, βEβ+,β0 or β+ /βA + alpha triplication(s)). Transfusion-dependent is defined as a history of receiving at least 120 mL/kg/year packed red blood cells or at least 8 transfusions per year in the past two years. The first 2 subjects enrolled must have a non- β0 β0 genotype.
  3. Genetic confirmation of α and β thalassemia diagnosis (β0β0, β+β0, β+β+, βEβ0, βEβ+, β0 or β+ /βA + alpha triplication(s)) by a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory is required.
  4. Clinically stable, score at least 70, and eligible to undergo Hematopoietic Stem Cell Transplantation ().
  5. Female subjects of must agree to use acceptable method(s) of from consent through at least 6 months after CHOP-ALS20 infusion
  6. Male subjects of reproductive capacity must agree to use effective contraception from start of mobilization through at least 6 months after CHOP-ALS20 infusion
  7. All potential treatment options including allogeneic HSCT (HLA-matched related, HLA-matched unrelated, and haploidentical) as well as FDA approved gene therapy options have been thoroughly discussed with the independent hematologist and/or transplant physician and subject agrees to proceed with this clinical trial.

Exclusion criteria

Exclusion Criteria:

  1. Prior receipt of or gene therapy
  2. More than one alpha globin gene deletions/mutations.
  3. Any prior or current (excluding adequately treated basal or squamous cell carcinoma of the skin)
  4. Known cancer predisposition syndrome
  5. Positive for -1, HIV-2, Human T Cell Lymphotropic Virus-1,2 (HTLV-1, HTLV-2) or active or active infection
  6. active bacterial, viral (including COVID-19 and influenza), fungal, or parasitic infection (temporary exclusion)
  7. Clinically significant bleeding disorder
  8. Evidence of cardiac dysfunction ( \<50% or shortening fraction \<27%) or clinically significant arrhythmia
  9. Evidence of advanced liver disease ( >5x the (ULN), >1.5 x ULN, direct > 3x ULN) not attributable to iron chelation therapy, or evidence of bridging fibrosis on liver or fibrosis stage of F3 or higher by magnetic resonance elastography (MRE) if obtained as part of clinical care
  10. Liver R2 or R2 MRI or liver biopsy with liver iron concentration 15 mg/g dw (temporary exclusion)
  11. Diffusion capacity of the lungs for carbon monoxide (DLco) \<50% of predicted (corrected for )
  12. Pulse oximetry in room air \<92%
  13. Evidence of renal dysfunction (creatinine >1.5x ULN or (GFR) \<70 ml/min/1.73 m2 based on cystatin C/creatinine equation)
  14. Cardiac T2 MRI \< 10 ms
  15. count \<100,000/mcL or \<1000/mcL except if attributed to benign ethnic neutropenia
  16. Unable to receive red cell transfusion (significant allo/auto immunization)
  17. Uncontrolled systemic hypertension
  18. Uncontrolled seizure disorder
  19. Diagnosis of a significant psychiatric disorder that could seriously impede the ability to participate in the study as determined by the investigator
  20. Immediate family member with a known or suspected Familial Cancer Syndrome
  21. to anesthesia
  22. For female subjects, pregnancy or breastfeeding
  23. Participation in another clinical trial of an drug within 30 days or 5 drug half-lives, whichever is longer, of screening (temporary exclusion)
  24. Any other condition that would render the subject ineligible for mobilization/apheresis and/or HSCT as determined by the investigator
Terms in these criteria, in plain language(21)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
12 participants (estimated)

Study arms

  • Experimental
    beta thalassemia

    This arm will evaluate the safety and efficacy of infusing autologous hematopoietic stem and progenitor cells (HSPC) transduced with the novel lentiviral vector ALS20 that encodes the human βA-T87Q-globin gene, following myeloablative conditioning with busulfan.

    Biological: ALS20

Interventions

  • BiologicalALS20

    novel lentiviral vector ALS20

06

What researchers measure

Primary outcomes

  1. Neutrophil Engraftment

    time to neutrophil engraftment

    Time frame: within 42 days after infusion

  2. Platelet Engraftment

    time to platelet engraftment

    Time frame: through end of treatment, an average 1 year

  3. Overall Survival at 2 years

    Survival status after treatment ends

    Time frame: 2 years after treatment ends

  4. Incidence of transplant related mortality

    Incidence of transplant related mortality within 100 days and within 1 year after infusion

    Time frame: 1 year after infusion

  5. Incidence of Graft Versus Host Disease

    any clinical evidence of graft versus host disease (GVHD)

    Time frame: through end of treatment, an average of 1 year

  6. Incidence of Vector-Derived Replication Competent Lentivirus

    The detection of vector-derived replication competent lentivirus in any subject throughout the study until end of treatment.

    Time frame: through end of treatment, an average of 1 year

  7. Insertional Oncogenesis

    The number of subjects with insertional oncogenesis

    Time frame: through the end of the study, up to 24 months

  8. Clonal Predominance

    The number of subjects with clonal predominance

    Time frame: through the end of the study, up to 24 months

  9. maintain total hemoglobin level of 9.0 g/dL or higher

    The proportion of subjects able to discontinue regular red cell transfusions and maintain total hemoglobin level of 9.0 g/dL or higher (average over 1-year period) in the absence of red cell transfusion(transfusion independence). Success is defined as a minimum of 4 to 6 subjects achieving this endpoint.

    Time frame: through the end of the study, up to 24 months

07

Study locations

1 site
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Status
Recruiting→Active, not recruiting
changed Oct 29, 2026
Show all 1 update
  1. Oct 29, 2026
    Recruiting→Active, not recruiting
    + 3 other changes: verification date, contact details and site details

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06364774
Responsible party
Sponsor
First posted
Apr 15, 2024
Start date
Apr 14, 2025
Primary completion
Dec 31, 2027 (estimated)
Completion
Dec 31, 2027 (estimated)
Last update
Oct 29, 2026

Study contacts

Janet Kwiatkowski, MD
principal investigator · Children's Hospital of Philadelphia

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.

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