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Pretransplant mogamulizumab against ATLL might increase the risk of acute GVHD and non-relapse mortality

Bone Marrow Transplantation volume 51, pages 725–727 (2016)Cite this article

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Adult T-cell leukemia/lymphoma (ATLL) is a peripheral T-cell neoplasm that is associated with human T-cell leukemia virus type I.1 Combination chemotherapies (such as mLSG15) against aggressive ATLL have been developed.2, 3 However, the prognosis is extremely poor and the median survival of patients with aggressive ATLL is still ~1 year with conventional chemotherapy.3 Mogamulizumab (anti-C-C chemokine receptor type 4 (CCR4) monoclonal antibody; MOG) was recently approved as a treatment for ATLL in Japan. Previous phase I and phase II studies of MOG monotherapy for aggressive ATLL showed that MOG was safe and effective in ATLL patients, even though long-term outcomes are unclear.4, 5

CCR4, a target of MOG, is highly expressed on regulatory T cells (Tregs), which is a pivotal player in the reconstitution of immune tolerance after allogeneic hematopoietic cell transplantation (allo-HCT).6, 7 Considering that Tregs are significantly depleted in vivo for several months after the administration of MOG (half-life 16–18 days), an important question is reasonably raised whether pretransplant administration of MOG may potentially exacerbate acute GVHD in ATLL patients.

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Acknowledgements

This research was supported by the Practical Research for Innovative Cancer Control from Japan Agency for Medical Research and Development, AMED. We thank the medical, nursing, data-processing, laboratory and clinical staff at our center for their important contributions to this study and their dedicated care of the patients.

Author contributions

YI and SF participated in research design, data analysis and writing of the paper; RT and TF participated in research design and writing of the paper; and all authors approved the submission of this study.

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Authors and Affiliations

  1. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Y Inoue, S Fuji & T Fukuda

  2. Juntendo University Graduate School of Medicine, Tokyo, Japan

    Y Inoue & S Fuji

  3. Blood Transfusion Division, National Cancer Center Hospital, Tokyo, Japan

    R Tanosaki

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  1. Y Inoue
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  2. S Fuji
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  3. R Tanosaki
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  4. T Fukuda
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Correspondence to S Fuji.

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Inoue, Y., Fuji, S., Tanosaki, R. et al. Pretransplant mogamulizumab against ATLL might increase the risk of acute GVHD and non-relapse mortality. Bone Marrow Transplant 51, 725–727 (2016). https://doi.org/10.1038/bmt.2015.315

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