title: Persistent complete remission of acute leukemic-phase CCR4-positive gamma-delta peripheral T-cell lymphoma by autologous stem cell transplantation with mogamulizumab.
abstract: Peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), frequently shows a poor outcome. Especially, expressions of CC chemokine receptor 4 (CCR4) and γδ T-cell receptor (TCR) are associated with worse prognosis in PTCL-NOS. We here report successful treatment with autologous peripheral blood stem cell transplantation (auto-PBSCT) combined with anti-CCR4 antibody mogamulizumab for a very rare case of CCR4+γδTCR+ PTCL-NOS that coexisted with Hodgkin's lymphoma. PTCL-NOS in this patient progressed to leukemic phase, whereas Hodgkin's lymphoma disappeared with standard chemotherapies within 4 years of the initial diagnosis. Leukemic-phase PTCL-NOS was refractory to several chemotherapies. However, auto-PBSCT following high-dose chemotherapy combined with pre- and post-transplant mogamulizumab, which is a humanized monoclonal antibody to CCR4, provided persistent complete remission of PTCL-NOS, despite residual γδTCR+ in the transplanted stem cell product, suggesting a purging effect of mogamulizumab. At 15 months after transplantation, we also found markedly fewer effector regulatory T cells, which may have contributed to prolonged remission. This case suggests that autologous stem cell transplantation combined with mogamulizumab may have a potential to cure T-cell neoplasms that express CCR4 including leukemic-phase PTCL-NOS.
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, Fukushima, 960-1295, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Furukawa
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, Fukushima, 960-1295, Japan. kazu-ike@fmu.ac.jp.|Department of Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan. kazu-ike@fmu.ac.jp.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, Fukushima, 960-1295, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohkawara
authors.affiliation: Department of Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Saito
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, Fukushima, 960-1295, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Koki
authors.initials: K
authors.lastname: Ueda
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, Fukushima, 960-1295, Japan.
authors.forename: Hayato
authors.initials: H
authors.lastname: Matsumoto
authors.affiliation: Department of Pathology and Diagnostic Pathology, Fukushima Medical University, Fukushima, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ohto
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, Fukushima, 960-1295, Japan.
authors.forename: Kazuei
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, Fukushima, 960-1295, Japan.
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D064592:Autografts; D006801:Humans; D008297:Male; D008875:Middle Aged; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000628:therapy; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000097:blood*; D054398:Receptors, CCR4 / Q000037:antagonists & inhibitors* / Q000097:blood; D012074:Remission Induction; D033581:Stem Cell Transplantation
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C515354:CCR4 protein, human; D016692:Receptors, Antigen, T-Cell, gamma-delta; D054398:Receptors, CCR4; C549035:mogamulizumab
keywords: Autologous stem cell transplantation; CCR4; Mogamulizumab; Peripheral T-cell lymphoma not otherwise specified; Purging