title: Colitis mimicking graft-versus-host disease during treatment with the anti-CCR4 monoclonal antibody, mogamulizumab.
abstract: A 57-year-old male with acute-type adult T cell leukemia-lymphoma (ATL) developed persistent watery, non-bloody diarrhea at a volume of 2-3 L/day following the administration of the anti-CC chemokine receptor 4 (CCR4) monoclonal antibody, mogamulizumab. An extensive examination revealed the absence of any pathogenic bacteria or parasites in his stool. Biopsied specimens from the colonic mucosa contained many small nests of apoptotic bodies in the colonic glands, which mimicked acute-colonic graft-versus-host disease. Activation of the auto-reactive immune system due to the depletion of regulatory T-cells by mogamulizumab was suspected as causative. Special attention should be paid to the risk of unique immune-related adverse events induced by mogamulizumab.
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan. kenjiishitsuka@fukuoka-u.ac.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishitsuka
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan.
authors.forename: Mutsunori
authors.initials: M
authors.lastname: Murahashi
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Katsuya
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Mogi
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Masaki
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan.
authors.forename: Chisato
authors.initials: C
authors.lastname: Kawai
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan.
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Goto
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan.
authors.forename: Masanao
authors.initials: M
authors.lastname: Ishizu
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Ikari
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takamatsu
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishibashi
authors.affiliation: Department of Pathology, Fukuoka University, Fukuoka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nimura
authors.affiliation: Department of Pathology, Fukuoka University, Fukuoka, Japan.
authors.forename: Morishige
authors.initials: M
authors.lastname: Takeshita
authors.affiliation: Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan, Fukuoka, 814-0180, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tamura
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects*; D003092:Colitis / Q000139:chemically induced / Q000175:diagnosis; D006086:Graft vs Host Disease / Q000139:chemically induced / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D054398:Receptors, CCR4 / Q000037:antagonists & inhibitors*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C515354:CCR4 protein, human; D054398:Receptors, CCR4; C549035:mogamulizumab
keywords: Adult T-cell lymphoma/leukemia; CCR4; Colitis; Immune-related adverse event; Mogamulizumab