The Impact of a Humanized CCR4 Antibody (Mogamulizumab) on Patients with Aggressive-Type Adult T-Cell Leukemia-Lymphoma Treated with Allogeneic Hematopoietic Stem Cell Transplantation
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- Kawano Noriaki
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
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- Kuriyama Takuro
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
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- Yoshida Shuro
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
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- Kawano Sayaka
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
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- Yamano Yoshihisa
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University Graduate School of Medicine
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- Marutsuka Kousuke
- Department of Pathology, Miyazaki Prefectural Miyazaki Hospital
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- Minato Seiichirou
- Department of Neurology, Miyazaki Prefectural Miyazaki Hospital
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- Yamashita Kiyoshi
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
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- Ochiai Hidenobu
- Trauma and Critical Care Center, Faculty of Medicine, University of Miyazaki Hospital
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- Shimoda Kazuya
- Division of Gastroenterology and Hematology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
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- Ishikawa Fumihiko
- Research Unit for Human Disease Models, RIKEN Research Center for Allergy and Immunology
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- Kikuchi Ikuo
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
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抄録
<p>Although a humanized CCR4 antibody (mogamulizumab) was reported to be effective for refractory adult T-cell leukemia-lymphoma (ATL), several reports regarding the use of mogamulizumab before allo-hematopoietic stem cell transplantation (HSCT) strongly indicated a high incidence of severe acute graft-versus-host-disease (GVHD) and treatment-related mortality (TRM). We retrospectively analyzed nine aggressive-type ATL patients who underwent allo-HSCT at a single institution in Miyazaki from 2006.1.1 to 2015.7.31. Among nine ATL patients, three had used mogamulizumab before treatment with allo-HSCT because of the poor control of refractory ATL. All three patients were treated with four to eight cycles of mogamulizumab. The interval from last administration of mogamulizumab to allo-HSCT was two to five months. All three patients with prior mogamulizumab treatment developed mild-moderate acute GVHD (grade 2) 28, 34, or 40 days after allo-HSCT. Acute GVHD was controlled by prednisolone treatment. Two patients in complete remission before allo-HSCT exhibited relatively prolonged survival (survival rate, 66%). Moreover, one patient developed human T-cell leukemia virus type 1-associated myelopathy-mimicking myelitis at five months after allo-HSCT. In contrast, two of six ATL patients without a history of mogamulizumab use survived (survival rate 33%). Thus, in cases of mogamulizumab use before treatment with allo-HSCT for refractory ATL, an appropriately long interval from the last administration of mogamulizumab to allo-HSCT may be one of factors to reduce TRM by acute GVHD, and to subsequently enhance graft-versus-tumor effects in ATL cases. Furthermore, caution is needed when administering mogamulizumab before allo-HSCT for severe GVHD and TRM.</p>
収録刊行物
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- Ｊｏｕｒｎａｌ ｏｆ Ｃｌｉｎｉｃａｌ ａｎｄ Ｅｘｐｅｒｉｍｅｎｔａｌ Ｈｅｍａｔｏｐａｔｈｏｌｏｇｙ
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Ｊｏｕｒｎａｌ ｏｆ Ｃｌｉｎｉｃａｌ ａｎｄ Ｅｘｐｅｒｉｍｅｎｔａｌ Ｈｅｍａｔｏｐａｔｈｏｌｏｇｙ 56 (3), 135-144, 2017
日本リンパ網内系学会
