Background: Gene therapy promises curative potential for sickle cell disease. Methods: 3-year follow-up of 40 patients with severe SCD treated with betibeglogene autotemcel (beti-cel). Primary outcome: transfusion independence and hemoglobin response. Results: Transfusion independence achieved in 90% of patients (median HbAT87Q: 9.8 g/dL). Vaso-occlusive crisis rate reduced by 84%. All engrafted patients-maintained vector-derived hemoglobin. No insertional oncogenesis observed. Conclusion: Beti-cel achieves durable transfusion independence with favorable safety profile in severe SCD, representing a functional cure
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