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Prevention of acute graft-versus-host disease in adult T-cell leukemia–lymphoma patients who received mogamulizumab before allogeneic hematopoietic cell transplantation

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Abstract

Mogamulizumab (Mog) is effective against adult T-cell leukemia–lymphoma (ATL), but as we reported previously, Mog increases the incidence of severe acute GVHD when administered before allogeneic hematopoietic cell transplantation (allo-HCT). Here, we report the cases of two ATL patients who did not develop acute GVHD despite receiving Mog before allo-HCT. Case 1: a 63-year-old female who underwent allo-HCT from an HLA-matched donor 2 months after the last dose of Mog. Case 2: a 47-year-old male with ATL that relapsed 3 months after first allo-HCT. He received eight doses of Mog and underwent a second allo-HCT from a haploidentical donor 4 months after the last dose of Mog. Mog blood levels were measured and lymphocytes analyzed by mass cytometry. Mog blood levels measured before starting the conditioning regimens were low. A small proportion of regulatory T cells (Tregs) was detected before and shortly after allo-HCT. When using Mog before allo-HCT, it is important to consider the number of Mog doses and the interval from the last dose of Mog to allo-HCT. Analyzing Mog blood levels and Treg counts before and after allo-HCT should also be useful.

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Acknowledgements

This research was partially supported by JSPS KAKENHI Grant Number 19K17861 and the Practical Research for Innovative Cancer Control Program of the Japan Agency for Medical Research and Development (20ck0106616h0001).

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Authors and Affiliations

  1. Department of Hematology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan

    Yoshitaka Inoue, Nao Nishimura, Masayuki Murai, Miho Matsumoto, Miho Watanabe, Asami Yamada, Mikiko Izaki, Kisato Nosaka & Masao Matsuoka

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  1. Yoshitaka Inoue
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  2. Nao Nishimura
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  3. Masayuki Murai
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  4. Miho Matsumoto
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  5. Miho Watanabe
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  6. Asami Yamada
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  7. Mikiko Izaki
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  8. Kisato Nosaka
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  9. Masao Matsuoka
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Contributions

YI, NN, MM, KI, KN, and MM participated in research design, data analysis, and writing of the paper. MM, MW, AY, and MI. participated in data analysis and writing of the paper. All authors approved the submission of this study.

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Correspondence to Yoshitaka Inoue.

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Conflict of interest

Dr. Nosaka has received research funds from Kyowa Kirin, consulting fees from Kyowa Kirin, and honoraria from Kyowa Kirin and Celgene. Dr. Matsuoka has received honoraria from Kyowa Kirin Co. The other authors declare no conflicts of interest associated with this manuscript.

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Inoue, Y., Nishimura, N., Murai, M. et al. Prevention of acute graft-versus-host disease in adult T-cell leukemia–lymphoma patients who received mogamulizumab before allogeneic hematopoietic cell transplantation. Int J Hematol 115, 435–439 (2022). https://doi.org/10.1007/s12185-021-03250-3

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  • DOI: https://doi.org/10.1007/s12185-021-03250-3

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