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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Chemo-refractory ATL with an effective mogamulizumab therapy, suffering from HBV reactivation

演題番号 : PS-1-233

徳永 雅仁 (Masahito Tokunaga):1、中野 伸亮 (Nobuaki Nakano):1、窪田 歩 (Ayumu Kubota):1、徳永 真弓 (Mayumi Tokunaga):1、糸山 貴浩 (Takahiro Itoyama):1、牧野 虎彦 (Torahiko Makino):1、竹内 昇吾 (Shogo Takeuchi):1、高塚 祥芝 (Yoshifusa Takatsuka):1、宇都宮 與 (Atae Utsunomiya):1

1:Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan

 

We report a chemo-refractory adult T-cell leukemia/lymphoma (ATL) patient obtained CR by a very effective mogamulizumab, and suffering from HBV reactivation during the treatment. In February 2012, 67 years old female was hospitalized with general lymph node swelling, pleural effusion, ascites, elevation of serum lactate dehydrogenase (LDH) and peripheral abnormal lymphocytosis. Left inguinal lymph node biopsy was done and she was diagnosed as having ATL. CHOP chemotherapy was started but serum LDH level and peripheral abnormal lymphocytes were not diminished and furthermore, skin and meningeal infiltration of ATL developed despite the treatment. Mogamulizumab has been administered in June 2012, after intrathecal chemotherapy, and then peripheral abnormal lymphocytes promptly disappeared and other ATL lesions changed for the better. Mogamulizumab therapy was very effective and continued for 8 cycles. But hepatitis B virus (HBV) DNA real-time PCR and hepatitis B surface antigen, which were conformed negative before treatment, were identified to become positive, indicating HBV reactivation. Entecavir was administered immediately and they returned negative next month. CR of ATL has been kept and de novo hepatitis of HBV has not developed. HBV reactivation is a serious problem in rituximab contained chemotherapy and Mogamulizumab should be also kept in mind. Mogamulizumab administration is one of the encouraging therapeutic strategies with ATL patient and we must not forget HBV DNA monitoring of ATL patient with a history of HBV infection.

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