The FDA has approved two gene therapies for sickle cell disease: exagamglogene autotemcel (Casgevy) from Vertex Pharmaceuticals and CRISPR Therapeutics, and lovotibeglogene autotemcel (Lyfgenia) from bluebird bio. Clinics are now evaluating how to effectively integrate these therapies into their treatment protocols, especially for patients who have not responded to existing disease-modifying therapies.
The director of the Sickle Cell Disease Program at Nemours Children’s Hospital discussed what clinics need in order to start administering gene therapy effectively. Some of them have already failed disease modifying therapies and are really looking for something else, but some haven't tried disease modifying therapies yet, and we might direct them that way first.” · Vertex Pharmaceuticals' and CRISPR Therapeutics’ gene editing therapy · exagamglogene autotemcel (exa-cel; marketed as Casgevy) and bluebird bio’s gene addition therapy · lovotibeglogene autotemcel (lovo-cel; marketed as Lyfgenia) were approved by the FDA for the treatment of sickle cell disease (SCD) in late 2023. 67th American Society of Hematology (ASH) Annual Meeting and Exposition, held December 6 to 9, 2025, in Orlando, Florida, CGTLive® spoke with Robin E. Miller, MD, the director of the Sickle Cell Disease Program at Nemours Children’s Hospital, to learn more about the practical considerations for treatment centers that are integrating or considering integrating gene therapy into their clinical care for SCD. Miller stressed that centers need key infrastructure, including SCD specialists, transplant experts, a robust blood bank, a stem cell lab, and experience with bone marrow transplant in SCD. Also important are psychosocial supports, including psychologists and social workers familiar with the unique challenges that families of patients with SCD face. She also explained that determining candidacy requires multidisciplinary input and shared decision making. Families must understand that while gene therapy is promising, it is a long process and carries risks. Some patients may be better suited for other therapies or traditional stem cell transplant, especially if a matched donor is available. Miller emphasized the importance of clearly explaining risks, benefits, and practical factors like recovery time and long-term follow-up. ... Stay at the forefront of cutting-edge science with CGT—your direct line to expert insights, breakthrough data, and real-time coverage of the latest advancements in cell and gene therapy.
Original title: “Robin E. Miller, MD, on Integrating Gene Therapy into Clinical Care for Sickle Cell Disease | CGTlive®”