Plasma exchange eliminates residual mogamulizumab but does not warrant prompt recovery of peripheral Treg levels

Hiroyuki Sugiura, Ken ichi Matsuoka, Yasuhisa Sando, Yusuke Meguri, Shuntaro Ikegawa, Makoto Nakamura, Miki Iwamoto, Takanori Yoshioka, Takeru Asano, Eisei Kondo, Keiko Fujii, Nobuharu Fujii, Yoshinobu Maeda

Research output: Contribution to journalArticle

Abstract

Mogamulizumab (Mog), a humanized anti-CCR4 antibody, provides an important treatment option for relapsed/refractory adult T cell leukemia/lymphoma. However, administration of Mog before allogenic hematopoietic stem cell transplantation has been reported to be a risk factor for severe acute graft-versus-host disease (GVHD). The etiological hypothesis is Mogamulizumab may eradicate CCR4-positive regulatory T cells (Tregs). Theoretically, Treg homeostasis and course of GVHD can be affected by plasma exchange (PE) with decreasing plasma Mog concentration. Here, we present a case of severe acute GVHD after pretransplantation Mog, in which PE was performed for liver failure. As a result, plasma Mog concentration was decreased but it did not lead to the prompt elevation of Treg levels in peripheral blood and clinical responses of GVHD were limited to partial remission. Our case suggests that recovery of donor-derived Treg in the acute phase after HSCT is multifactorial and the single procedure of PE-based Mog depletion does not necessarily warrant the quick restoration of Treg homeostasis.

Original languageEnglish
Pages (from-to)472-474
Number of pages3
JournalTransfusion and Apheresis Science
Volume58
Issue number4
DOIs
Publication statusPublished - Aug 2019

Keywords

  • Graft-versus-host disease
  • Mogamulizumab
  • Plasma exchange
  • Regulatory T cells

ASJC Scopus subject areas

  • Hematology

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