Cytomegalovirus Pneumonia after Anti-CC-chemokine Receptor 4 Monoclonal Antibody (Mogamulizumab) Therapy in an Angioimmunoblastic T-cell Lymphoma Patient

Intern Med. 2016;55(6):673-5. doi: 10.2169/internalmedicine.55.5644. Epub 2016 Mar 15.

Abstract

Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive T-cell lymphoma. A 63-year-old man was diagnosed with AITL. He received 6 cycles of CHOP therapy, but showed progressive disease. Subsequently, he received ESHAP chemotherapy; however, it was not effective. He received mogamulizumab (an anti-CCR4 monoclonal antibody). After 4 cycles, his respiratory condition worsened and he was diagnosed with cytomegalovirus (CMV) pneumonia. Despite antiviral and antibiotic therapy, he died. We speculate that the combination of progressive lymphoma with mogamulizumab and chemotherapy likely caused CMV pneumonia. Because mogamulizumab therapy causes immunosuppression, if CMV pneumonia is suspected, then rapid treatment should be initiated.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antibodies, Monoclonal, Humanized / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Antiviral Agents / administration & dosage
  • Cisplatin / administration & dosage
  • Cyclophosphamide / administration & dosage
  • Cytarabine / administration & dosage
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / etiology*
  • Cytomegalovirus Infections / immunology
  • Disease Progression
  • Doxorubicin / administration & dosage
  • Drug Resistance, Neoplasm
  • Etoposide / administration & dosage
  • Fatal Outcome
  • Humans
  • Immunoblastic Lymphadenopathy / drug therapy*
  • Immunoblastic Lymphadenopathy / immunology
  • Immunoblastic Lymphadenopathy / physiopathology
  • Lymphoma, T-Cell / drug therapy*
  • Lymphoma, T-Cell / immunology
  • Lymphoma, T-Cell / physiopathology
  • Male
  • Methylprednisolone / administration & dosage
  • Middle Aged
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / etiology*
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / virology
  • Prednisone / administration & dosage
  • Receptors, CCR4 / antagonists & inhibitors*
  • Vincristine / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents
  • CCR4 protein, human
  • Receptors, CCR4
  • Cytarabine
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Cisplatin
  • Prednisone
  • Methylprednisolone
  • mogamulizumab

Supplementary concepts

  • CHOP protocol
  • ESAP protocol