Satoshi Iyama1, Tsutomu Sato2, Hirofumi Ohnishi3, Yuji Kanisawa4, Shuichi Ohta5, Takeshi Kondo6, Akio Mori7, Yutaka Tsutsumi8, Hiroyuki Kuroda9, Yasutaka Kakinoki10, Satoshi Yamamoto11, Tohru Takahashi12, Motohiro Shindo13, Yoshihiro Torimoto14, Kazuya Sato15, Hiroshi Iwasaki16, Yoshihito Haseyama17, Kyuhei Kohda18, Yasuhiro Nagamachi19, Yasuo Hirayama20, Hajime Sakai21, Yasuji Hirata22, Takashi Fukuhara23, Hiroshi Ikeda2, Masayoshi Kobune2, Junji Kato24, Mitsutoshi Kurosawa25. 1. Department of Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan. Electronic address: iyama@sapmed.ac.jp. 2. Department of Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan. 3. Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan. 4. Department of Hematology/Oncology, Oji General Hospital, Tomakomai, Japan. 5. Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan. 6. Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. 7. Department of Internal Medicine, Aiiku Hospital, Sapporo, Japan. 8. Department of Internal Medicine, Hakodate Municipal Hospital, Hakodate, Japan. 9. Department of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital, Muroran, Japan. 10. Department of Hematology, Asahikawa City Hospital, Asahikawa, Japan. 11. Department of Hematology, Sapporo City General Hospital, Sapporo, Japan. 12. Department of Hematology, Tenshi Hospital, Sapporo, Japan. 13. Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan. 14. Oncology Center, Asahikawa Medical University Hospital, Asahikawa, Japan. 15. Department of Hematology/Oncology, Hokkaido Prefectural Welfare Federation of Agricultural Cooperative (P.W.F.A.C.) Asahikawa-Kosei General Hospital, Asahikawa, Japan. 16. Department of Internal Medicine, Hokkaido Prefectural Welfare Federation of Agricultural Cooperative (P.W.F.A.C.) Sapporo Kosei General Hospital, Sapporo, Japan. 17. Department of Hematology, KKR Sapporo Medical Center, Tonan Hospital, Sapporo, Japan. 18. Department of Hematology and Oncology, Asahikawa Red Cross Hospital, Asahikawa, Japan. 19. Department of Hematology, Sapporo Kiyota Hospital, Sapporo, Japan. 20. Department of Hematology Oncology, Higashi Sapporo Hospital, Sapporo, Japan. 21. Department of Hematology, Teine Keijinkai Hospital, Sapporo, Japan. 22. Department of Hematology and Oncology, Hakodate Red Cross Hospital, Hakodate, Japan. 23. Department of Palliative Care Medicine, Hokkaido Prefectural Welfare Federation of Agricultural Cooperative (P.W.F.A.C.) Sapporo-Kosei General Hospital, Sapporo, Japan. 24. Department of Clinical Oncology, Sapporo Medical University School of Medicine, Sapporo, Japan. 25. Department of Hematology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
Abstract
BACKGROUND: Mogamulizumab, a defucosylated humanized monoclonal antibody targeting C-C chemokine receptor 4, recently became available for the treatment of adult T-cell leukemia/lymphoma (ATL). We conducted a multicenter retrospective study of the efficacy of mogamulizumab in ATL treatment in patients on Hokkaido Island, Japan. MATERIALS AND METHODS: A total of 125 patients with ATL treated from January 2010 to December 2014 in 20 hospitals affiliated with the Hokkaido Hematology Study Group were enrolled in the present retrospective study. RESULTS: Of the 125 ATL patients, 62 (46.6%) presented with the acute type, 51 (38.3%) with the lymphoma type, and 12 (9.0%) with the chronic type; the latter group included 7 unfavorable chronic cases. The median age at diagnosis was 68 years (range, 35-86 years). The median survival for those with acute, lymphoma, and unfavorable chronic types was 302, 279, and 921 days, respectively. Advanced age, high lactate dehydrogenase level, poor performance status (3-4), and the existence of B symptoms were unfavorable prognostic factors for overall survival (OS). Survival rate calculated from the day of diagnosis was significantly higher in patients treated with mogamulizumab. The OS of individuals receiving hematopoietic stem cell transplantation (HSCT) was superior to that of the non-HSCT group. The median interval between the last mogamulizumab dose and allogeneic HSCT was 38 days (range, 21-53 days). Of the 22 HSCT recipients who were not treated with mogamulizumab, overall acute graft-versus-host disease (aGVHD) and grade III-IV aGVHD occurred in 12 (54.5%) and 3 (13.6%) patients, respectively. However, overall aGVHD and grade III-IV aGVHD developed in 8 (88.9%) and 3 (33.3%) of the 9 HSCT recipients treated with mogamulizumab, respectively. CONCLUSION: Mogamulizumab improves OS in patients with ATL, although its use in HSCT patients might trigger severe GVHD. Determining the optimal pre-HSCT mogamulizumab treatment regimen is thus a priority.
BACKGROUND:Mogamulizumab, a defucosylated humanized monoclonal antibody targeting C-C chemokine receptor 4, recently became available for the treatment of adult T-cell leukemia/lymphoma (ATL). We conducted a multicenter retrospective study of the efficacy of mogamulizumab in ATL treatment in patients on Hokkaido Island, Japan. MATERIALS AND METHODS: A total of 125 patients with ATL treated from January 2010 to December 2014 in 20 hospitals affiliated with the Hokkaido Hematology Study Group were enrolled in the present retrospective study. RESULTS: Of the 125 ATL patients, 62 (46.6%) presented with the acute type, 51 (38.3%) with the lymphoma type, and 12 (9.0%) with the chronic type; the latter group included 7 unfavorable chronic cases. The median age at diagnosis was 68 years (range, 35-86 years). The median survival for those with acute, lymphoma, and unfavorable chronic types was 302, 279, and 921 days, respectively. Advanced age, high lactate dehydrogenase level, poor performance status (3-4), and the existence of B symptoms were unfavorable prognostic factors for overall survival (OS). Survival rate calculated from the day of diagnosis was significantly higher in patients treated with mogamulizumab. The OS of individuals receiving hematopoietic stem cell transplantation (HSCT) was superior to that of the non-HSCT group. The median interval between the last mogamulizumab dose and allogeneic HSCT was 38 days (range, 21-53 days). Of the 22 HSCT recipients who were not treated with mogamulizumab, overall acute graft-versus-host disease (aGVHD) and grade III-IV aGVHD occurred in 12 (54.5%) and 3 (13.6%) patients, respectively. However, overall aGVHD and grade III-IV aGVHD developed in 8 (88.9%) and 3 (33.3%) of the 9 HSCT recipients treated with mogamulizumab, respectively. CONCLUSION:Mogamulizumab improves OS in patients with ATL, although its use in HSCT patients might trigger severe GVHD. Determining the optimal pre-HSCT mogamulizumab treatment regimen is thus a priority.