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International Journal of Hematology
Published in: International Journal of Hematology 2/2019

01-02-2019 | Case Report

Epstein–Barr virus-related diffuse large B-cell lymphoma in mogamulizumab-treated adult T-cell leukemia with incomplete T-cell reconstitution

Authors: Kazuharu Kamachi, Takero Shindo, Masaharu Miyahara, Kazutaka Kitaura, Michiaki Akashi, Tadasu Shin-I, Ryuji Suzuki, Koichi Oshima, Shinya Kimura

Published in: International Journal of Hematology | Issue 2/2019

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Abstract

Adult T-cell leukemia (ATL) is an aggressive mature T-cell malignancy with a poor prognosis. The anti-C–C motif chemokine receptor 4 (CCR4) antibody mogamulizumab (moga) reduces ATL cells and induces reconstitution of polyclonal T cells; however, ATL cases often remain resistant and moga sometimes causes fatal immunopathology. Epstein–Barr virus (EBV)-related B-cell lymphoma develops in severely immunocompromised subjects, and is particularly associated with impaired T-cell immunity. Here, we report an ATL patient who had received conventional chemotherapy plus moga, and subsequently developed EBV-related diffuse large B-cell lymphoma (DLBCL) of the central nervous system. Next-generation sequencing-based T-cell receptor repertoire analyses identified residual abnormal clones and revealed that reconstitution of polyclonal T cells was incomplete, even after moga treatment. Furthermore, a skin rash that developed after moga treatment was found to contain ATL clones. This case suggests that the limited therapeutic effects of moga and incomplete T-cell reconstitution are associated with severely impaired T-cell immunity and subsequent development of EBV-related DLBCL.
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Metadata
Title
Epstein–Barr virus-related diffuse large B-cell lymphoma in mogamulizumab-treated adult T-cell leukemia with incomplete T-cell reconstitution
Authors
Kazuharu Kamachi
Takero Shindo
Masaharu Miyahara
Kazutaka Kitaura
Michiaki Akashi
Tadasu Shin-I
Ryuji Suzuki
Koichi Oshima
Shinya Kimura
Publication date
01-02-2019
Publisher
Springer Japan
Published in
International Journal of Hematology / Issue 2/2019
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-018-2552-x

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