演題詳細

ポスター / Poster

ポスター 31 (Poster 31) :ATL:移植モガムリズマブ

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
今泉 芳孝 (Yoshitaka Imaizumi):1
1:長崎大学病院 血液内科
 
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Allogeneic stem cell transplantation after administration of mogamulizumab for refractory ATL

演題番号 : PS-1-230

吉井 由美 (Yumi Yoshii):1,2、松村 弥生 (Yayoi Matsumura):1、朴 将源 (Shogen Boku):1、上辻 由里 (Yuri Kamitsuji):1、川端 健二 (Kenji Kawabata):3、丸山 京子 (Kyoko Maruyama):4、橋本 尚子 (Hisako Hashimoto):5、魚嶋 伸彦 (Nobuhiko Uoshima):1

1:Department of Hematology, Matsushita Memorial Hospital, Osaka, Japan、2:Oncology Center, Nara Medical University, Kashihara, Japan、3:Department of Clinical Pathology, Matsushita Memorial Hospital, Osaka, Japan、4:Division of cell processing Center, Institute of Biomedical Research and Innovation Hospital, Kobe, Japan、5:Department of cell therapy, Institute of Biomedical Research and Innovation Hospital, Kobe, Japan

 

[Introduction] Although the survivals of relapsed adult T-cell leukemia (ATL) patients have been improved with the advent of mogamulizumab, allogeneic stem cell transplantation (allo-SCT) is still the only curative treatment. We report a case of refractory ATL who received HLA-haploidentical SCT one month after mogamulizumab infusion.
[Case report] 52-year-old man with acute type of ATL, who was refractory to mLSG15 regimen, received 8 cycles of mogamulizumab treatment, and achieved complete remission. One month later, he underwent allo-PBSCT from HLA 3 antigen mismatched son (Conditioning regimen: FLU 125mg/m2, MEL 140mg/m2, ATG 3mg/kg. GVHD prophylaxis: mPSL and tacrolimus). Engraftment was achieved on day 9, chimerism analysis on day 11 demonstrated full donor chimera. After discontinuation of steroid, he developed grade 3 GVHD in the liver and the skin, which improved with re-administration of steroid and additional ATG treatment. Complete ATL remission was maintained throughout the period after SCT. Treg/CD4+Tcell ratio was less than 3% during active GVHD period, but increased over 10% from day174, as the GVHD activity decreasing.
[Discussion] Mogamulizumab has exhibited potent antitumor effects, on the other hand, it caused severe GVHD by reducing Treg cells for a long time. In our case, Treg cells has recovered from day 174 after SCT, that may provide telling clues about when Treg cells will recover after SCT following mogamulizumab therapy. Further studies are required to ensure the best timing of SCT after mogamulizumab therapy.

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