Severe graft-versus-host disease after allogeneic hematopoietic stem cell transplantation with residual mogamulizumab concentration
Letter to the Editor
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We read with great interest the two articles by Tsubokura et al. and Ishitsuka et al. on allogeneic hematopoietic stem cell transplantation (allo-HSCT) for adult T-cell leukemia/lymphoma (ATLL) [ 1, 2]. Regimens containing mogamulizumab (Mog), an anti-CC chemokine receptor 4 (CCR4) monoclonal antibody, are expected to achieve good disease control before allo-HSCT and may result in low relapse rate after allo-HSCT. However, there is a concern that the use of Mog before allo-HSCT may cause severe acute graft-versus-host disease (aGVHD), as Mog eradicates normal CCR4-positive cells, including regulatory T cells (Tregs). Fuji et al. reported that Mog administration is associated with significantly increased risk of severe aGVHD due to such reduction in Tregs [ 3]. At present, there is no consensus on how to use Mog before allo-HSCT in Japan. Recently, Tsubokura et al. reported that monitoring of Tregs was useful for avoiding severe aGVHD [ 1]. Ishitsuka et al. demonstrated that the interval...
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Conflict of interest
None of the authors have any financial conflicts of interest related with this work.
- 3.Fuji S, Inoue Y, Utsunomiya A, Moriuchi Y, Uchimaru K, Choi I, et al. Pretransplantation Anti-CCR4 Antibody Mogamulizumab Against Adult T-Cell Leukemia/Lymphoma Is Associated With Significantly Increased Risks of Severe and Corticosteroid-Refractory Graft-Versus-Host Disease, Nonrelapse Mortality, and Overall Mortality. J Clin Oncol. 2016;34:3426–33.CrossRefPubMedGoogle Scholar
© The Japanese Society of Hematology 2018