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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Toxic epidermal necrolysis associated with mogamulizumab treatment of adult T-cell leukemia/lymphoma

演題番号 : PS-1-232

丹波 和奈 (Kazuna Tanba):1、河田 英里 (Eri Kawata):1、内山 人二 (Hitoji Uchiyama):1、赤荻 照章 (Teruaki Akaogi):1、小林 裕 (Yutaka Kobayashi):1、大東 淳子 (Junko Daitou):2、池田 佳弘 (Yoshihiro Ikeda):2、山野 剛 (Takeshi Yamano):3、桂 奏 (Kanade Katsura):3

1:Department of Hematology, Kyoto Second Red Cross Hospital、2:Department of Dermatology, Kyoto Second Red Cross Hospital、3:Department of Pathology, Kyoto Second Red Cross Hospital

 

Mogamulizumab is a humanized anti-CCR4 antibody and has meaningful antitumor activity in high risk ATL. However, not a few skin-related severe adverse events were reported. We experienced a case of toxic epidermal necrolysis (TEN) associated with mogamulizumab, successfully controlled. A 74 years old woman was first diagnosed as lymphomatous ATL in August 2012. She soon became refractory to her first chemotherapy and was treated with VECP and mogamulizumab from December. She completed her 4th administration with Grade 1 skin rushes. On day 4 of the 5th, she became feverous, followed by focal skin rushes. They extended to whole body and improved by topical steroid and oral antihistamine. On day 10, she claimed blisters on her soles and oral mucosal erosions. We gave systemic corticosteroids, but skin rashes became fulminant. Skin biopsy revealed liquefaction and superficial perivascular inflammation. We diagnosed her as TEN and started steroid pulse (mPSL 1g) from day11. Skin rashes improved but became active again on day 15, so we added immunoglobulin besides PSL. They healed gradually, and re-epithelialization was observed in two weeks. TEN is the most severe form of drug-induced skin reaction and its mortality rate is reported as 30-50%. The etiology of TEN is not completely understood, however several theories including immunologic mechanisms, reactive drug metabolites, or interactions between these two have been reported. As ATL patients are originally severely immunosuppressed, we may have to pay more attention to the skin-related side effects in using mogamulizumab.

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