Suwabe Tatsuya, Shibasaki Yasuhiko, Kaihatsu Akane, Katagiri Takayuki, Miyakoshi Shukuko, Fuse Kyoko, Kobayashi Hironori, Ushiki Takashi, Moriyama Masato, Takizawa Jun, Narita Miwako, Sone Hirohito, Masuko Masayoshi
Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine.
Rinsho Ketsueki. 2017;58(1):32-36. doi: 10.11406/rinketsu.58.32.
A 62-year-old man with CHOP refractory adult T-cell leukemia/lymphoma (ATLL) received anti-CC chemokine receptor 4 antibody (mogamulizumab) combined with CHOP and achieved complete remission. At 71 days after the final administration of mogamulizumab, he received umbilical cord blood transplantation (CBT) using reduced intensity conditioning. Umbilical cord blood engraftment was confirmed on day16. Grade II acute graft-versus-host disease (GVHD) was diagnosed on day60 and was controlled by administration of methylprednisolone. There was no evidence of relapse at 9 months after CBT. Ratios of regulatory T cells in CD4 positive T cells were remarkably low during all of these periods. Since mogamulizumab reduces regulatory T cells, the frequency and severity of acute GVHD were reported to be increased in patients administered mogamulizumab before allogenic stem cell transplantation. Further experiences are needed for selecting optimal donor sources, the portability period and GVHD prophylaxis for patients using mogamulizumab before allogeneic stem cell transplantation.
一名62岁患有难治性成人T细胞白血病/淋巴瘤（ATLL）的男性患者接受了抗CC趋化因子受体4抗体（莫加莫拉单抗）联合CHOP方案治疗并实现完全缓解。在最后一次使用莫加莫拉单抗71天后，他接受了减低强度预处理的脐带血移植（CBT）。第16天确认脐带血植入。第60天诊断出Ⅱ级急性移植物抗宿主病（GVHD），通过给予甲泼尼龙得到控制。CBT后9个月没有复发迹象。在所有这些时期，CD4阳性T细胞中的调节性T细胞比例都非常低。由于莫加莫拉单抗会减少调节性T细胞，据报道，在异基因干细胞移植前使用莫加莫拉单抗的患者中，急性GVHD的发生率和严重程度会增加。对于在异基因干细胞移植前使用莫加莫拉单抗的患者，需要更多经验来选择最佳供体来源、移植窗口期和预防GVHD。
