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Wiskott-Aldrich syndrome (WAS) is a primary immunodeficiency disease characterized by microthrombocytopenia, eczema, infections and an increased risk for autoimmune manifestations and malignancies.
Features include always present findings: Abnormal natural killer cell physiology, Eczematoid dermatitis, Low platelet count (thrombocytopenia), and Decreased mean platelet volume; and very common findings: Increased circulating IgE concentration. 42 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Blood and immune system | 12 | Low iron red blood cell count (iron deficiency anemia), Recurrent lower respiratory tract infections, Large vessel vasculitis |
Digestive system | 4 | Diarrhea, Inflammation of the large intestine, Ulcerative colitis |
Lab test results | 3 | Increased circulating IgE concentration, Increased circulating IgA concentration, Decreased specific anti-polysaccharide antibody level |
Lungs and breathing | 3 | Recurrent lower respiratory tract infections, Recurrent pneumonia, Recurrent upper respiratory tract infections |
Skin | 2 | Eczematoid dermatitis, Abnormal delayed hypersensitivity skin test |
Brain and nerves | 1 | Recurrent meningitis |
Kidneys and urinary system | 1 | Kidney disease (nephropathy) |
Ears | 1 | Recurrent otitis media |
WAS-related disorders comprise a spectrum that includes Wiskott-Aldrich syndrome, X-linked thrombocytopenia (XLT), and X-linked neutropenia (XLN). There is considerable overlap between phenotypes. WAS-related disorders usually present in infancy with low platelet counts, small platelet size, significant risk of bleeding, and, in some individuals, eczema and/or abnormal lymphocyte function with susceptibility to serious bacterial, viral, and fungal infections. Autoimmune disorders and lymphomas are frequent. The clinical phenotype may worsen with age. The clinical complications can vary widely, even in the same kindred. The prognosis for individuals with WAS-related disorders has improved as a result of improved treatment. The WAS-related disorders clinical score (WAS score) is derived from clinical and laboratory features including thrombocytopenia, eczema, immunodeficiency, autoimmune disorders, and malignancy . WAS scores, which range between 0 and 5, facilitate the clinical categorization of individuals and may be useful in predicting disease severity . Individuals with a higher WAS score (e.g., 5) at a younger age (e.g., during the first two years of life) may be at increased risk for morbidity and mortality . As progression of the disease can occur at a later age, individuals may transition from a lower to a higher WAS score (e.g., some individuals originally diagnosed with XLT [score of 1 to 2] may develop autoimmunity or cancer later in life [score of 5]) . Table 2. WAS-Related Disorders: Clinical Scoring System
Feature | Score |
|---|
WAS function has not been fully characterized.
Wiskott-Aldrich syndrome is caused by mutations in the WAS gene on chromosome X.
Individuals with Wiskott-Aldrich syndrome show remarkably variable expressivity of clinical findings. At least 300 different disease-causing variants and six mutational hot spots in WAS have been described. Loss-of-function variants in WAS cause Wiskott-Aldrich syndrome and XLT, whereas gain-of-function variants in the region encoding the conserved GTPase binding domain of Wiskott-Aldrich syndrome protein (WASP) lead to XLN . Specific pathogenic variants are not universally associated with a specific clinical phenotype, and disease severity varies considerably within families, even between monozygotic twins , which suggests epigenetic factors, other genetic alterations, and environmental factors (e.g., Epstein-Barr virus [EBV]) could contribute to the phenotypic heterogeneity .
Source: GeneReviews — "WAS-Related Disorders"
Penetrance is complete in males with a WAS pathogenic variant.
Source: GeneReviews — "WAS-Related Disorders"
WAS-related disorders include a phenotypic spectrum ranging from severe to mild. The phenotypes and their diagnostic criteria, modified from the recommendations of the European Society of Immunodeficiencies (ESID), are listed here. Wiskott-Aldrich syndrome should be suspected in a male with the following:
Source: GeneReviews — "WAS-Related Disorders"
Idiopathic thrombocytopenic purpura (ITP) should be considered in the differential diagnosis of males presenting early in life with thrombocytopenia. In contrast to Wiskott-Aldrich syndrome, ITP is associated with increased platelet size and increased reticulated platelet count. ITP is usually transient and self-limited. Genetic disorders of interest in the differential diagnosis Wiskott-Aldrich syndrome include those listed in .
Table 3.
Genetic Disorders of Interest in the Differential Diagnosis of Wiskott-Aldrich Syndrome
Gene | Disorder | MOI | Features of Disorder | Comment
Overlapping w/Wiskott-Aldrich syndrome | Distinguishing from Wiskott-Aldrich syndrome
| Wiskott-Aldrich syndrome 2 (OMIM 614493) | AR | • Recurrent infections, eczema, thrombocytopenia
Source: GeneReviews — "WAS-Related Disorders"
Genetic testing for WAS is available. Testing is considered confirmatory for diagnosis.
Biomarker and diagnostic research for Wiskott-Aldrich syndrome has been reported in the published literature.
1 FDA-approved treatment is available for Wiskott-Aldrich syndrome, including etuvetidigene autotemcel (waskyra, approved 2025). An additional 2 compounds hold orphan drug designation.
Brand Name | Generic Name | Mechanism | Approved | Market Status |
|---|---|---|---|---|
waskyra | etuvetidigene autotemcel | — | 2025 | Available |
The following drugs have received orphan drug designation from the FDA for Wiskott-Aldrich syndrome. Orphan designation reflects regulatory interest and does not indicate approval for treatment.
Brand Name | Generic Name | Sponsor | Designated | Exclusivity End | Designation Status |
|---|---|---|---|---|---|
autologous cluster of differentiation 34 positive (CD34+) hematopoietic stem/progenitor cells transduced with the LVMWAS lentiviral vector encoding the human Wiskott-Aldrich Syndrome protein | autologous cluster of differentiation 34 positive (CD34+) hematopoietic stem/progenitor cells transduced with the LVMWAS lentiviral vector encoding the human Wiskott-Aldrich Syndrome protein | CSL Behring | 2024 | — | Designated |
Autologous CD34+ hematopoietic stem and progenitor cells modified ex vivo with a lentiviral vector that restores endogenously regulated expression of WASp | Autologous CD34+ hematopoietic stem and progenitor cells modified ex vivo with a lentiviral vector that restores endogenously regulated expression of WASp | ImmunoVec |
No clinical practice guidelines for WAS-related disorders have been published. In the absence of published guidelines, the following recommendations are based on the authors' personal experience managing individuals with this disorder.
To establish the extent of disease and needs in an individual diagnosed with a WAS-related disorder, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended.
Table 4.
WAS-Related Disorders: Recommended Evaluations Following Initial Diagnosis
System/Concern | Evaluation | Comment
| • Platelet count size
Assessment for complications assoc w/ bleeding
Referral to hematologist for periodic CBCs to monitor platelet counts assess for anemia assoc w/bleeding
| Occasionally, mild-to-moderate thrombocytopenia can present later in childhood, mimicking ITP but w/o response to oral steroids.
| Skin should be examined for eczema. | Eczema is a variable feature.
| Referral to immunologist for assessment of immunodeficiency: | Recurrent infections are a variable feature.
Circumcision of an at-risk newborn male should not be undertaken in the presence of thrombocytopenia. The use of over-the-counter medications should be discussed with a physician, as some medications can interfere with platelet function. When possible, elective surgical procedures should be deferred until after HSCT.
Source: GeneReviews — "WAS-Related Disorders"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for access to information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "WAS-Related Disorders"
5 trials found
To monitor existing manifestations, the individual's response to supportive care, and the emergence of new manifestations, the evaluations summarized in are recommended. Table 7. WAS-Related Disorders: Recommended Surveillance
System/Concern | Evaluation | Frequency |
|---|---|---|
Eczema | Skin exam | Annually |
Immunodeficiency | Assessment w/immunologist | As recommended by immunologist Infection |
Autoimmune disease | Clinical assessment for autoimmune dysfunction | Annually Malignancy |
Source: GeneReviews — "WAS-Related Disorders"
Phenotype severity distribution: 4 always present features, 1 very common feature, 6 common features.
Estimated prevalence: 1-9 in 1,000,000 (Rare).
5 clinical trials registered. Interventions under study include gene therapy, biologic therapy, and drug therapy. Pipeline includes 1 PHASE3, 1 PHASE2, 2 PHASE1. Research is primarily sponsored by academic and government institutions.
NCT ID | Title | Phase | Sponsor | Status |
|---|---|---|---|---|
[NCT02333760](https://clinicaltrials.gov/study/NCT02333760) | Long Term Safety Follow up of Haematopoietic Stem Cell Gene Therapy for the Wiskott Aldrich Syndrome | PHASE1 | Genethon | ACTIVE_NOT_RECRUITING |
[NCT01852370](https://clinicaltrials.gov/study/NCT01852370) | Sequential Cadaveric Lung and Bone Marrow Transplant for Immune Deficiency Diseases | PHASE1 | Paul Szabolcs | ENROLLING_BY_INVITATION |
[NCT03837483](https://clinicaltrials.gov/study/NCT03837483) | A Clinical Study to Evaluate the Use of a Cryopreserved Formulation of OTL-103 in Subjects With Wiskott-Aldrich Syndrome | PHASE3 | Fondazione Telethon | ACTIVE_NOT_RECRUITING |
[NCT01652092](https://clinicaltrials.gov/study/NCT01652092) | Allogeneic Hematopoietic Stem Cell Transplant for Patients With Primary Immune Deficiencies | NA | Masonic Cancer Center, University of Minnesota | ACTIVE_NOT_RECRUITING |
[NCT01821781](https://clinicaltrials.gov/study/NCT01821781) | Immune Disorder HSCT Protocol | PHASE2 | Washington University School of Medicine | UNKNOWN |
164 publications have been identified in PubMed for Wiskott-Aldrich syndrome. Research spans Basic Science / Preclinical (44%), Review / Meta-Analysis (19%), and Case Report / Case Series (15%).
Research Type | Count | % of Total |
|---|---|---|
Laboratory research | 72 | 44% |
Research summaries | 31 | 19% |
Patient case studies | 24 | 15% |
Disease patterns and progression | 14 | 9% |
New treatment approaches | 8 | 5% |
Other research | 7 |
Ober P (2026). [PMID: 41333711](https://pubmed.ncbi.nlm.nih.gov/41333711/). *J Hum Immun*. [Gene Therapy / Novel Therapeutics]
Park HG (2026). [PMID: 41474627](https://pubmed.ncbi.nlm.nih.gov/41474627/). *J Cell Biol*. [Basic Science / Preclinical]
Arnold DE (2026). [PMID: 42242424](https://pubmed.ncbi.nlm.nih.gov/42242424/). *J Allergy Clin Immunol Pract*. [Clinical Trial Publication]
Malik MA (2026). [PMID: 30969660](https://pubmed.ncbi.nlm.nih.gov/30969660/). *Unknown Journal*. [Review / Meta-Analysis]
Consolini R (2026). [PMID: 42123030](https://pubmed.ncbi.nlm.nih.gov/42123030/). *J Clin Med*. [Review / Meta-Analysis]
Midena F (2026). [PMID: 41512872](https://pubmed.ncbi.nlm.nih.gov/41512872/). *Cell Stem Cell*. [Clinical Trial Publication]
Younis NS (2026). [PMID: 41929524](https://pubmed.ncbi.nlm.nih.gov/41929524/). *Hum Mutat*. [Review / Meta-Analysis]
Razaghian A (2026). [PMID: 41718912](https://pubmed.ncbi.nlm.nih.gov/41718912/). *J Clin Immunol*. [Epidemiology / Natural History]
de Mambro L (2026). [PMID: 41225257](https://pubmed.ncbi.nlm.nih.gov/41225257/). *Int J Hematol*. [Review / Meta-Analysis]
He T (2026). [PMID: 41495793](https://pubmed.ncbi.nlm.nih.gov/41495793/). *Chin Med*. [Gene Therapy / Novel Therapeutics]
Data assembled from 10 of 12 sources · Last updated Nov 3, 2026, 11:15 AM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center
Phenotype
Thrombocytopenia | Eczema | Immunodeficiency |
Absent | Absent | Absent |
Present | Absent | Absent |
Present | Mild or transient | Infrequent infections |
Present | Persistent but responsive | Recurrent infections |
Present | Severe, not controlled | Severe infections |
Present | Any | Any |
Source: GeneReviews — "WAS-Related Disorders"
2023
— |
Designated |
T-cell subsets
Ig levels
Vaccine titers
WASP expression
|
| Clinical assessment for autoimmune dysfunction | Rarely the presenting manifestation but can complicate disease course.
| Clinical assessment for manifestations of lymphoma
| By genetics professionals1 | To obtain a pedigree inform affected persons their families re...
Source: GeneReviews — "WAS-Related Disorders"
Testing and diagnosis research | 5 | 3% |
Clinical study results | 3 | 2% |
AI-curated news mentioning Wiskott-Aldrich syndrome
Updated Oct 28, 2026
ema perspective on the regulatory approval of waskyra the first gene therapy for the treatment of wiskott aldrich syndrome
Gene therapy cut severe infections 93% in Wiskott-Aldrich syndrome, using patients’ own modified stem cells to treat a rare inherited immune disorder. Gene therapy cut severe infections 93% in Wiskott-Aldrich syndrome, using patients’ own modified stem cells to treat a rare inherited immune disorder.Magnific Wiskott-Aldrich syndrome is a rare inherited immune disorder affecting boys that causes eczema, immune deficiency, and bleeding. A new study shows that infusing gene-corrected stem cells provides lasting protection for patients. The FDA approved this therapy in December 2025 after citing a 93% drop in severe infections. Analysis of where the gene landed in the DNA showed blood production drawn from many different corrected cells, with no sign that the virus had disturbed cancer genes. The treatment still carries risks. Nineteen patients experienced serious adverse events. Most were infections. The study had no control group, which the authors note is inevitable in an ultra-rare disease. The FDA requires a · 15-year follow-up study to track secondary cancer risk. The path to approval is also unusual. The therapy began at an academic center, passed through pharmaceutical development and returned to Fondazione Telethon, an Italian nonprofit organization, which secured approval in Europe and the U.S. The FDA describes it as the first cell and gene therapy approved by a nonprofit applicant. A durable treatment raises the stakes for early diagnosis. In this study, symptoms started at a median age of about four months, and diagnosis followed at a median age of one year. Genetic testing of mothers in affected families, and · genome sequencing at birth, can identify boys with the disease before the first serious infection. The lesson of this study reaches beyond one rare disease.
from oncogenesis to approval the lentiviral gene therapy revolution in wiskott aldrich syndrome
Fondazione Telethon for Waskyra™, ... disorder and the first approved gene therapy developed by a nonprofit organization. Omeros for YARTEMLEA®, the first and only FDA-approved treatment for adults and children 2 years and older with hematopoietic stem cell ... Fondazione Telethon for Waskyra™, a breakthrough gene therapy for Wiskott-Aldrich syndrome (WAS) that represents the first FDA-approved gene therapy for a primary immunodeficiency disorder and the first approved gene therapy developed by a nonprofit organization. Omeros for YARTEMLEA®, the first and only FDA-approved treatment for adults and children 2 years and older with hematopoietic stem cell transplant–associated thrombotic microangiopathy (TA-TMA), a significant and often fatal complication of stem cell transplantation. Their progress in addressing the unique challenges of these conditions is also contributing knowledge, approaches, and breakthroughs that help move science and the entire rare disease field forward." ... Mighty Therapeutics for FORZINITY™, the first therapy for Barth syndrome — a very rare, progressive, and life-limiting genetic disease affecting mitochondria — shown to improve muscle strength and quality of life. Stephen Kingsmore, MD, DSc of California, recipient of a Medical & Scientific Trailblazer Award for founding the Rady Children’s Institute for Genomic Medicine NORD Rare Disease Center of Excellence, where he pioneered whole genome sequencing, rapid genetic testing as a clinical tool, and the first comprehensive genomic carrier screening test. Mark Skinner, JD of New York, recipient of the Lifetime Achievement Award for his advocacy for bleeding disorders in New York, the U.S., and worldwide through the World Federation of Hemophilia, the National Bleeding Disorders Foundation, the HHS Advisory Committee on Blood and Tissue Safety and Availability, and NORD's Board of Directors. View original content to download multimedia:https://www.prnewswire.com/news-releases/nord-announces-the-2026-rare-impact-award-honorees-advancing-innovation-research-and-advocacy-for-rare-diseases-302889723.html · SOURCE National Organization for Rare Disorders (NORD®) ... Jazz Pharmaceuticals, Inc. Omeros Corporation ... Lilly presents early data supporting GLP-1/GIP candidate’s potential in depression, alcohol use disorder ... Get daily news updates when you subscribe to GenePool!
Recent research highlights large vessel vasculopathy as an underrecognized complication in Wiskott-Aldrich syndrome. This discovery may prompt further investigation into the cardiovascular risks associated with this rare genetic disorder.