Mogamulizumab Treatment Prior to Allogeneic Hematopoietic Stem Cell Transplantation Induces Severe Acute Graft-versus-Host Disease

Takeshi Sugio, Koji Kato, Takatoshi Aoki, Takanori Ohta, Noriyuki Saito, Shuro Yoshida, Ichiro Kawano, Hideho Henzan, Masanori Kadowaki, Ken Takase, Tsuyoshi Muta, Kohta Miyawaki, Takuji Yamauchi, Takahiro Shima, Shuichiro Takashima, Yasuo Mori, Goichi Yoshimoto, Kenjiro Kamezaki, Katsuto Takenaka, Hiromi IwasakiRyosuke Ogawa, Yuju Ohno, Tetsuya Eto, Tomohiko Kamimura, Toshihiro Miyamoto, Koichi Akashi

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Mogamulizumab (MOG), a humanized anti-CC chemokine receptor 4 (CCR4) monoclonal antibody, has recently played an important role in the treatment of adult T cell leukemia/lymphoma (ATLL). Because CCR4 is expressed on normal regulatory T cells as well as on ATLL cells, MOG may accelerate graft-versus-host disease (GVHD) by eradicating regulatory T cells in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, there is limited information about its safety and efficacy in patients treated with MOG before allo-HSCT. In the present study, 25 patients with ATLL were treated with MOG before allo-HSCT, after which 18 patients (72%) achieved remission. The overall survival and progression-free survival at 1 year post-transplantation were 20.2% (95% CI, 6.0% to 40.3%) and 15.0% (95% CI, 4.3% to 32.0%), respectively. The cumulative incidence of acute GVHD was 64.0% (95% CI, 40.7% to 80.1%) for grade II-IV and 34.7% (95% CI, 15.8% to 54.4%) for grade III-IV. The cumulative incidence of transplantation-related mortality (TRM) was 49.0% (95% CI, 27.0% to 67.8%). Six of 7 patients with acute GVHD grade III-IV died from GVHD, which was the leading cause of death. In particular, a shorter interval from the last administration of MOG to allo-HSCT was associated with more severe GVHD. MOG use before allo-HSCT may decrease the ATLL burden; however, it is associated with an increase in TRM due to severe GVHD. Because MOG is a potent anti-ATLL agent, new treatment protocols should be developed to integrate MOG at suitable doses and timing of administration to minimize unwanted GVHD development.

Original languageEnglish
Pages (from-to)1608-1614
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume22
Issue number9
DOIs
Publication statusPublished - Sep 1 2016

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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