title: A Multicenter Retrospective Study of Mogamulizumab Efficacy in Adult T-Cell Leukemia/Lymphoma.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan. Electronic address: iyama@sapmed.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iyama
authors.affiliation: Department of Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ohnishi
authors.affiliation: Department of Hematology/Oncology, Oji General Hospital, Tomakomai, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kanisawa
authors.affiliation: Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ohta
authors.affiliation: Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Department of Internal Medicine, Aiiku Hospital, Sapporo, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Mori
authors.affiliation: Department of Internal Medicine, Hakodate Municipal Hospital, Hakodate, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tsutsumi
authors.affiliation: Department of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital, Muroran, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Department of Hematology, Asahikawa City Hospital, Asahikawa, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Kakinoki
authors.affiliation: Department of Hematology, Sapporo City General Hospital, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Hematology, Tenshi Hospital, Sapporo, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Shindo
authors.affiliation: Oncology Center, Asahikawa Medical University Hospital, Asahikawa, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Torimoto
authors.affiliation: Department of Hematology/Oncology, Hokkaido Prefectural Welfare Federation of Agricultural Cooperative (P.W.F.A.C.) Asahikawa-Kosei General Hospital, Asahikawa, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Internal Medicine, Hokkaido Prefectural Welfare Federation of Agricultural Cooperative (P.W.F.A.C.) Sapporo Kosei General Hospital, Sapporo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwasaki
authors.affiliation: Department of Hematology, KKR Sapporo Medical Center, Tonan Hospital, Sapporo, Japan.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Haseyama
authors.affiliation: Department of Hematology and Oncology, Asahikawa Red Cross Hospital, Asahikawa, Japan.
authors.forename: Kyuhei
authors.initials: K
authors.lastname: Kohda
authors.affiliation: Department of Hematology, Sapporo Kiyota Hospital, Sapporo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nagamachi
authors.affiliation: Department of Hematology Oncology, Higashi Sapporo Hospital, Sapporo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hirayama
authors.affiliation: Department of Hematology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Sakai
authors.affiliation: Department of Hematology and Oncology, Hakodate Red Cross Hospital, Hakodate, Japan.
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Hirata
authors.affiliation: Department of Palliative Care Medicine, Hokkaido Prefectural Welfare Federation of Agricultural Cooperative (P.W.F.A.C.) Sapporo-Kosei General Hospital, Sapporo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukuhara
authors.affiliation: Department of Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ikeda
authors.affiliation: Department of Hematology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kobune
authors.affiliation: Department of Clinical Oncology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
authors.affiliation: Department of Hematology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Kurosawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007564:Japan; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C549035:mogamulizumab
keywords: ATL; CCR4; GVHD; Mogamulizumab; Treg