PRETRANSPLANT ANTI-CCR4 ANTIBODY AGAINST ADULT T CELL LEUKEMIA/LYMPHOMA WAS ASSOCIATED WITH SIGNIFICANTLY INCREASED RISKS OF SEVERE/STEROID-REFRACTORY GVHD, NON-RELAPSE MORTALITY AND OVERALL MORTALITY
(Abstract release date: 05/19/16)
EHA Library. Fuji S. 06/12/16; 135312; S818
Dr. Shigeo Fuji
Contributions
Contributions
Abstract
Abstract: S818
Type: Oral Presentation
Presentation during EHA21: On Sunday, June 12, 2016 from 08:00 - 08:15
Location: Hall C15
Background
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one important treatment option for patients with aggressive adult T cell leukemia/lymphoma (ATLL). Mogamulizumab (anti-CCR4 monoclonal antibody; Mog) was recently approved as a treatment for ATLL. There are major concerns regarding the possible adverse effects of pretransplant Mog, as Mog depletes regulatory T cells (Tregs) for several months.
Aims
Here, we aimed to assess the impact of pretransplant Mog on the clinical outcomes after allo-HSCT.
Methods
We included 996 allo-HSCT recipients aged 70 years old or younger with aggressive ATLL who were diagnosed between 2000 to 2013, and received intensive chemotherapy using multiple chemotherapeutic drugs as first-line therapy. Before allo-HSCT, 82 patients received Mog with a median interval 45 days from the last Mog to allo-HSCT.
Results
Pretransplant Mog was associated with an increased risk of grade III-IV acute GVHD (30.9% vs. 17.2%, P < 0.01) and refractoriness to systemic steroid for acute GVHD (48.9% vs. 23.5%, P < 0.01). The cumulative incidence of 1-year non-relapse mortality was significantly higher in patients with pretransplant Mog compared to those without Mog (43.7% vs. 25.1%, P < 0.01). The probability of 1-year overall survival was also significantly inferior in patients with pretransplant Mog compared to those without Mog (49.4% vs. 32.3%, P < 0.01). In particular, use of Mog with intervals < 50 days to allo-HSCT was associated with a dismal clinical outcome.
Conclusion
Our study clearly showed that pretransplant Mog significantly worsened the clinical outcome, which strongly supports the important relevance of Tregs in allo-HSCT in humans as in animal models. In clinical practice, Mog should be cautiously used for patients with ATLL who are eligible for allo-HSCT.
Session topic: Stem cell transplantation - Clinical 2
Keyword(s): ATLL, Graft-versus-host disease (GVHD), Hematopoietic cell transplantation, Regulatory T cell
Type: Oral Presentation
Presentation during EHA21: On Sunday, June 12, 2016 from 08:00 - 08:15
Location: Hall C15
Background
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one important treatment option for patients with aggressive adult T cell leukemia/lymphoma (ATLL). Mogamulizumab (anti-CCR4 monoclonal antibody; Mog) was recently approved as a treatment for ATLL. There are major concerns regarding the possible adverse effects of pretransplant Mog, as Mog depletes regulatory T cells (Tregs) for several months.
Aims
Here, we aimed to assess the impact of pretransplant Mog on the clinical outcomes after allo-HSCT.
Methods
We included 996 allo-HSCT recipients aged 70 years old or younger with aggressive ATLL who were diagnosed between 2000 to 2013, and received intensive chemotherapy using multiple chemotherapeutic drugs as first-line therapy. Before allo-HSCT, 82 patients received Mog with a median interval 45 days from the last Mog to allo-HSCT.
Results
Pretransplant Mog was associated with an increased risk of grade III-IV acute GVHD (30.9% vs. 17.2%, P < 0.01) and refractoriness to systemic steroid for acute GVHD (48.9% vs. 23.5%, P < 0.01). The cumulative incidence of 1-year non-relapse mortality was significantly higher in patients with pretransplant Mog compared to those without Mog (43.7% vs. 25.1%, P < 0.01). The probability of 1-year overall survival was also significantly inferior in patients with pretransplant Mog compared to those without Mog (49.4% vs. 32.3%, P < 0.01). In particular, use of Mog with intervals < 50 days to allo-HSCT was associated with a dismal clinical outcome.
Conclusion
Our study clearly showed that pretransplant Mog significantly worsened the clinical outcome, which strongly supports the important relevance of Tregs in allo-HSCT in humans as in animal models. In clinical practice, Mog should be cautiously used for patients with ATLL who are eligible for allo-HSCT.
Session topic: Stem cell transplantation - Clinical 2
Keyword(s): ATLL, Graft-versus-host disease (GVHD), Hematopoietic cell transplantation, Regulatory T cell
Abstract: S818
Type: Oral Presentation
Presentation during EHA21: On Sunday, June 12, 2016 from 08:00 - 08:15
Location: Hall C15
Background
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one important treatment option for patients with aggressive adult T cell leukemia/lymphoma (ATLL). Mogamulizumab (anti-CCR4 monoclonal antibody; Mog) was recently approved as a treatment for ATLL. There are major concerns regarding the possible adverse effects of pretransplant Mog, as Mog depletes regulatory T cells (Tregs) for several months.
Aims
Here, we aimed to assess the impact of pretransplant Mog on the clinical outcomes after allo-HSCT.
Methods
We included 996 allo-HSCT recipients aged 70 years old or younger with aggressive ATLL who were diagnosed between 2000 to 2013, and received intensive chemotherapy using multiple chemotherapeutic drugs as first-line therapy. Before allo-HSCT, 82 patients received Mog with a median interval 45 days from the last Mog to allo-HSCT.
Results
Pretransplant Mog was associated with an increased risk of grade III-IV acute GVHD (30.9% vs. 17.2%, P < 0.01) and refractoriness to systemic steroid for acute GVHD (48.9% vs. 23.5%, P < 0.01). The cumulative incidence of 1-year non-relapse mortality was significantly higher in patients with pretransplant Mog compared to those without Mog (43.7% vs. 25.1%, P < 0.01). The probability of 1-year overall survival was also significantly inferior in patients with pretransplant Mog compared to those without Mog (49.4% vs. 32.3%, P < 0.01). In particular, use of Mog with intervals < 50 days to allo-HSCT was associated with a dismal clinical outcome.
Conclusion
Our study clearly showed that pretransplant Mog significantly worsened the clinical outcome, which strongly supports the important relevance of Tregs in allo-HSCT in humans as in animal models. In clinical practice, Mog should be cautiously used for patients with ATLL who are eligible for allo-HSCT.
Session topic: Stem cell transplantation - Clinical 2
Keyword(s): ATLL, Graft-versus-host disease (GVHD), Hematopoietic cell transplantation, Regulatory T cell
Type: Oral Presentation
Presentation during EHA21: On Sunday, June 12, 2016 from 08:00 - 08:15
Location: Hall C15
Background
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one important treatment option for patients with aggressive adult T cell leukemia/lymphoma (ATLL). Mogamulizumab (anti-CCR4 monoclonal antibody; Mog) was recently approved as a treatment for ATLL. There are major concerns regarding the possible adverse effects of pretransplant Mog, as Mog depletes regulatory T cells (Tregs) for several months.
Aims
Here, we aimed to assess the impact of pretransplant Mog on the clinical outcomes after allo-HSCT.
Methods
We included 996 allo-HSCT recipients aged 70 years old or younger with aggressive ATLL who were diagnosed between 2000 to 2013, and received intensive chemotherapy using multiple chemotherapeutic drugs as first-line therapy. Before allo-HSCT, 82 patients received Mog with a median interval 45 days from the last Mog to allo-HSCT.
Results
Pretransplant Mog was associated with an increased risk of grade III-IV acute GVHD (30.9% vs. 17.2%, P < 0.01) and refractoriness to systemic steroid for acute GVHD (48.9% vs. 23.5%, P < 0.01). The cumulative incidence of 1-year non-relapse mortality was significantly higher in patients with pretransplant Mog compared to those without Mog (43.7% vs. 25.1%, P < 0.01). The probability of 1-year overall survival was also significantly inferior in patients with pretransplant Mog compared to those without Mog (49.4% vs. 32.3%, P < 0.01). In particular, use of Mog with intervals < 50 days to allo-HSCT was associated with a dismal clinical outcome.
Conclusion
Our study clearly showed that pretransplant Mog significantly worsened the clinical outcome, which strongly supports the important relevance of Tregs in allo-HSCT in humans as in animal models. In clinical practice, Mog should be cautiously used for patients with ATLL who are eligible for allo-HSCT.
Session topic: Stem cell transplantation - Clinical 2
Keyword(s): ATLL, Graft-versus-host disease (GVHD), Hematopoietic cell transplantation, Regulatory T cell
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