Pratik, chemotherapy is required to prepare the patient for the procedure. Gene therapy is a permanent cure. It is very good news that some of the earlier patients in the trials are no longer chelating. Also, their new product appears to be improved, which is good news as they head to a beta zero only trial.
The drug we've been following that increases Hb is Luspatercept. This is not a cure, but an ongoing treatment, but it will probably be the more easily accessible, as gene therapy will come with a high price tag. Phase 3 trials for Luspatercept are now full and underway. There is a good chance it will hit the market by 2020 if the trials go well. The early trials have gone exceptionally well. Depending on the transfusion needs of the patient, this drug should eliminate the need for transfusion in intermedia patients, including many with HbE beta thal, and also greatly reduce the transfusion and chelation requirements of almost all thals. The drug reduces ineffective erythropoiesis, which lowers iron absorption, while also reducing the amount of iron being taken from transfusions. I anticipate that many patients currently using drugs like hydroxyurea and thalidomide will switch to Luspatercept once it is available. I see the other drugs as a temporary measure until better comes along. Better is really close.