Background: Mogamulizumab, an anti-CCR4 monoclonal antibody, is approved for relapsed/refractory (r/r) aggressive adult T-cell leukemia/lymphoma (ATL), although durable responses are limited.
Objective: To identify biomarkers associated with mogamulizumab efficacy, focusing on host immune status and known prognostic factors.
Methods: We retrospectively analyzed 315 patients with r/r aggressive ATL using real-world data from Japan. Clinical and prognostic variables were analyzed for association with overall survival (OS), stratified by mogamulizumab use.
Results: Among 315 patients, 97 received mogamulizumab (Moga [+]). One-year OS was higher in Moga (+) than Moga (-) patients (51.2 % vs. 34.0 %, p = 0.006). Multivariate analysis identified age < 70, PS 0-1, cCa < 11 mg/dL, albumin ≥3.5 g/dL, LDH < 265 IU/L, LMR ≥ 2.6, and Moga (+) use as independent predictors of OS. In Moga (+) patients, cCa and LMR remained independent prognostic factors.
Conclusion: LMR is a novel prognostic factor in r/r ATL and may provide useful information when considering mogamulizumab-based treatment.
Keywords: Adult T-cell leukemia-lymphoma; lymphocyte/monocyte ratio; mogamulizumab; predictive markers.
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