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Significant detrimental impact of pre-transplant mogamulizumab on the post-transplant outcome with a short interval between the last mogamulizumab and transplantation

Bone Marrow Transplantation volume 60, pages 552–554 (2025)Cite this article

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Letter to the Editor

Adult T-cell leukemia-lymphoma (ATL) is a rare hematological malignancy with a dismal clinical outcome [1]. Allogeneic hematopoietic cell transplantation (allo-HCT) is one standard treatment option to achieve a cure [1]. However, some patients have relapsed or refractory disease, in which allo-HCT is not highly effective with a low overall survival (OS) rate [2]. In that case, mogamulizumab (Mog) could be an option to achieve sufficient disease control before allo-HCT [3]. However, using Mog before allo-HCT could increase the risk of severe acute graft-versus-host disease (aGVHD) and overall mortality, possibly due to a profound depletion of regulatory T cells after allo-HCT [2, 4]. Particularly, using Mog with a short interval before allo-HCT was associated with an increased risk of overall mortality [2, 4]. When Mog is used for relapsed or refractory ATL before allo-HCT, it is recommended to have an interval of more than 50 days before allo-HCT [2]. As data on allo-HCT after the use of Mog is still limited, we assessed the impact of pre-transplant Mog in patients with aggressive ATL using a recent dataset of Japanese registry data.

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Fig. 1: Clinical outcomes grouped according to the use of mogamulizumab and the interval between the last Mog and allogeneic hematopoietic cell transplantation.

Data availability

The datasets generated during and/or analysed during the current study are not publicly available due due to ethical restrictions stipulating that providing such data would exceed the scope of the recipients’ and donors’ consent for research use in the registry, but are possibly available from the corresponding author on reasonable request.

References

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Funding

This study was supported in part by research funding from Japan Agency for Medical Research and Development (Grant/Award Number: 23ck0106860h0001).

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Authors and Affiliations

  1. Department of Hematology, Osaka International Cancer Institute, Osaka, Japan

    Shigeo Fuji & Jun Ishikawa

  2. Department of Hematology, Imamura General Hospital, Kagoshima, Japan

    Masahito Tokunaga & Nobuaki Nakano

  3. Hematology, Oncology & Cardiovascular medicine, Kyushu University Hospital, Fukuoka, Japan

    Koji Kato & Yasuo Mori

  4. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Takero Shindo

  5. Department of Hematology, Sasebo City General Hospital, Nagasaki, Japan

    Junya Makiyama & Yukiyoshi Moriuchi

  6. Transfusion and Cell Therapy Unit, Nagasaki University Hospital, Nagasaki, Japan

    Hidehiro Itonaga

  7. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Ayumu Ito & Takahiro Fukuda

  8. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  9. Department of Hematology, Hokkaido University Hospital, Hokkaido, Japan

    Yuta Hasegawa

  10. Department of Hematology and Rheumatology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan

    Kenji Ishitsuka & Makoto Yoshimitsu

  11. Department of Hematology, Sapporo Hokuyu Hospital, Hokkaido, Japan

    Shuichi Ota

  12. Department of Hematology and Cell Therapy, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan

    Youko Suehiro

  13. Department of Hematology, National Hospital Organization Kyusyu Medical Center, Fukuoka, Japan

    Ken Takase

  14. Division of Hematology, Jichi Medical University, Tochigi, Japan

    Yoshinobu Kanda

  15. Department of Hematology/Oncology, Tokai University School of Medicine, Kanagawa, Japan

    Makoto Onizuka

  16. Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan

    Yoshiko Atsuta

  17. Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Aichi, Japan

    Yoshiko Atsuta

Authors
  1. Shigeo Fuji
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  2. Masahito Tokunaga
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  3. Koji Kato
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  4. Nobuaki Nakano
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  5. Takero Shindo
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  6. Junya Makiyama
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  7. Hidehiro Itonaga
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  8. Ayumu Ito
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  9. Tetsuya Eto
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  10. Jun Ishikawa
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  11. Yuta Hasegawa
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  12. Kenji Ishitsuka
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  13. Yukiyoshi Moriuchi
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  14. Shuichi Ota
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  15. Yasuo Mori
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  16. Youko Suehiro
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  17. Ken Takase
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  18. Yoshinobu Kanda
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  19. Makoto Onizuka
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  20. Takahiro Fukuda
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  21. Yoshiko Atsuta
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  22. Makoto Yoshimitsu
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Contributions

S.F. and M.Y. designed the study. S.F., M.T., K.K., N.N., T.S., J.M., H.I., A.I., T.E., J.I., Y.H., K.I., Y.M., S.O., Y.M., S.Y., K.T., Y.K., M.O., T.F., Y.A., and M.Y. collected the data. S.F. performed the statistical analysis. S.F., M.T., K.K., N.N., and M.Y. wrote the manuscript. All authors agreed to submit the final version of the manuscript.

Corresponding author

Correspondence to Shigeo Fuji.

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Competing interests

The authors declare no competing interests.

Ethical approval and consent to participate

This study was approved by the institutional review board of the Kagoshima University Hospital, Kagoshima, Japan (No. 220276). The study was conducted in accordance with the Declaration of Helsinki. All participating patients provided written informed consent to the Japanese Society for Transplantation and Cellular Therapy (JSTCT) upon registration. Our observational study used data that were de-identified by the JSTCT before being shared with us.

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Fuji, S., Tokunaga, M., Kato, K. et al. Significant detrimental impact of pre-transplant mogamulizumab on the post-transplant outcome with a short interval between the last mogamulizumab and transplantation. Bone Marrow Transplant 60, 552–554 (2025). https://doi.org/10.1038/s41409-025-02517-1

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  • DOI: https://doi.org/10.1038/s41409-025-02517-1

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