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Effect of anti‐ CCR 4 monoclonal antibody (mogamulizumab) on adult T ‐cell leukemia–lymphoma: Cutaneous adverse reactions may predict the prognosis
Author(s) -
Yonekura Kentaro,
Kanzaki Tamotsu,
Gunshin Kanayo,
Kawakami Nobuyo,
Takatsuka Yoshifusa,
Nakano Nobuaki,
Tokunaga Masahito,
Kubota Ayumu,
Takeuchi Shogo,
Kanekura Takuro,
Utsunomiya Atae
Publication year - 2014
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.12419
Subject(s) - ccr4 , lymphoma , medicine , monoclonal antibody , immunology , leukemia , monoclonal , adult t cell leukemia/lymphoma , cytotoxic t cell , antibody , cc chemokine receptors , t cell leukemia , chemokine , biology , immune system , chemokine receptor , biochemistry , in vitro
Adult T ‐cell leukemia–lymphoma ( ATL ) is one of the most malignant lymphomas with poor prognosis. ATL cells express CC chemokine receptor 4 ( CCR 4) and mogamulizumab, a monoclonal antibody against CCR 4 that exhibits very strong cytotoxicity for ATL cells via antibody‐dependent cellular cytotoxicity. Although its effect is dramatic in ATL , serious adverse reactions such as S tevens– J ohnson syndrome have been reported. However, these eruptions can appear as therapeutic signs of mogamulizumab. We evaluated the effectiveness of mogamulizumab in five acute‐type ATL patients. Peripheral blood ( PB ) and lymph nodes ( LN ) were affected in three and four patients, respectively. In PB , complete response ( CR ) was obtained in all three patients and partial response ( PR ) was recorded in LN of one patient. In skin lesions, four of five patients manifested CR ; in two, the lesions worsened after the start of mogamulizumab treatment and subsequently improved. In these lesions, CD 4 + 8 − 25 + ATL cells were replaced by CD 3 + 8 + cytotoxic T cells. Cutaneous adverse reactions ( CAR ) developed in two patients with CR ; they did not show a relapse of ATL over the course of 9 months. Our findings suggest that mogamulizumab should be continued and surface marker evaluation should be performed even in patients whose skin lesions show aggravation, and that CAR may be a marker for a favorable prognosis.