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Research Letter
June 2018

Potential Association of Anti-CCR4 Antibody Mogamulizumab and Graft-vs-Host Disease in Patients With Mycosis Fungoides and Sézary Syndrome

Author Affiliations
  • 1Department of Dermatology, Stanford University, Stanford, California
  • 2Division of Oncology, Department of Medicine, Stanford University, Stanford, California
  • 3Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University, Stanford, California
JAMA Dermatol. 2018;154(6):728-730. doi:10.1001/jamadermatol.2018.0884

Mogamulizumab is a monoclonal antibody against CC chemokine receptor 4 (CCR4) that has efficacy in patients with relapsed and refractory T-cell lymphomas and has an overall response rate of 36.8% in mycosis fungoides (MF) and Sézary syndrome (SS).1 Concerns exist regarding the use of mogamulizumab in patients prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) because CCR4 is highly expressed on both malignant and regulatory T cells. Depletion of regulatory T cells following mogamulizumab is thought to augment antitumor response but may also potentiate graft-vs-host disease (GVHD). Significant reduction of peripheral blood and tissue regulatory T cells was observed in patients with cutaneous T-cell lymphoma treated with mogamulizumab.2 Retrospective studies in patients with adult T-cell leukemia/lymphoma have reported that treatment with mogamulizumab prior to transplantation may be associated with an increased risk of severe, steroid-refractory acute GVHD, as well as poor clinical outcomes.3 We evaluated patients with advanced MF or SS who received mogamulizumab before allo-HSCT.

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