Prognostic value of lymphocyte-to-monocyte ratio in relapsed/refractory adult T-cell Leukemia/lymphoma patients receiving mogamulizumab.

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.