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Safety of mogamulizumab for relapsed ATL after allogeneic hematopoietic cell transplantation

Bone Marrow Transplantation volume 54, pages 338–342 (2019)Cite this article

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Adult T-cell leukemia-lymphoma (ATL) is a peripheral T cell neoplasm caused by human T-cell leukemia virus type 1 (HTLV-1) infection. Although antiviral therapy (such as Zidovudine plus interferon alpha) or combination chemotherapies are used for the treatment of patients with aggressive ATL (acute and lymphoma types), the prognosis of these patients is still very poor [1, 2]. On the other hand, some allogeneic hematopoietic cell transplantation (allo-HCT) recipients with aggressive ATL have achieved long-term survival, suggesting the presence of graft-versus-ATL effects after allo-HCT [3]. However, relapse after allo-HCT is still a major obstacle to cure in recipients of allo-HCT [4].

Mogamulizumab (Mog), an anti CC chemokine receptor 4 (CCR4) antibody, was developed for use in patients with aggressive ATL, and previous studies showed that Mog was safe and effective in this population [5]. However, CCR4 is also highly expressed by regulatory T cells (Tregs), which play pivotal roles in the reconstitution of immune tolerance after allo-HCT [6]. Therefore, a major concern is that administration of Mog before or after allo-HCT could potentially increase the risk of graft-versus-host disease (GVHD) by depletion of Tregs. We previously reported that the use of Mog before allo-HCT increased severe acute GVHD and non-relapse mortality (NRM) [7, 8]. However, it remains unknown whether administration of Mog after allo-HCT increases the risk of subsequent GVHD. Hence, we conducted a retrospective analysis of the safety and efficacy of Mog in patients with relapsed aggressive ATL after allo-HCT.

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Acknowledgements

This research was partially supported by the Practical Research for Innovative Cancer Control Program of the Japan Agency for Medical Research and Development (15Ack0106136h0002).

Author contributions

YI, SE, NM, YK, TS, KK, AT, KI, NN, KN and MM participated in research design, data analysis, and writing of the paper. SF and TF participated in writing of the paper. All authors approved the submission of this study.

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Authors and Affiliations

  1. Department of Hematology, Kumamoto University Hospital, Kumamoto, Japan

    Yoshitaka Inoue, Shinya Endo, Naofumi Matsuno, Yoshitaka Kikukawa, Takafumi Shichijo, Kenichi Koga, Ayumi Takaki, Kouta Iwanaga, Nao Nishimura, Kisato Nosaka & Masao Matsuoka

  2. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan

    Yoshitaka Inoue, Shigeo Fuji & Takahiro Fukuda

  3. Department of Hematology, Osaka International Cancer Institute, Osaka, Japan

    Shigeo Fuji

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  1. Yoshitaka Inoue
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Inoue, Y., Endo, S., Matsuno, N. et al. Safety of mogamulizumab for relapsed ATL after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 54, 338–342 (2019). https://doi.org/10.1038/s41409-018-0291-5

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