Graft-Versus-Tumour Effect Following Allogeneic Haematopoietic Stem Cell Transplantation in a Paediatric Patient With Mogamulizumab-Treated Primary Cutaneous Peripheral T-Cell Lymphoma.
This report describes a 10-year-old with chemotherapy-refractory pcPTCL-NOS who received mogamulizumab before allo-HSCT, subsequently developed severe steroid-refractory acute graft-versus-host disease, and had spontaneously regressing lesions at prior lymphoma sites whose biopsy supported a graft-versus-lymphoma interpretation.
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This report describes a 10-year-old with chemotherapy-refractory pcPTCL-NOS who received mogamulizumab before allo-HSCT, subsequently developed severe steroid-refractory acute graft-versus-host disease, and had spontaneously regressing lesions at prior lymphoma sites whose biopsy supported a graft-versus-lymphoma interpretation.
Research significance
The case provides clinical evidence consistent with an alloimmune graft-versus-lymphoma effect after mogamulizumab and allo-HSCT; it raises, but does not establish, the hypothesis that transplant timing and immune management could be optimized to preserve antitumor activity while reducing severe graft-versus-host disease.
Source abstract
INTRODUCTION: Primary cutaneous peripheral T-cell lymphoma, not otherwise specified (pcPTCL-NOS), is exceptionally rare in children, and evidence guiding diagnosis and treatment is limited. CASE PRESENTATION: A 10-year-old boy with pcPTCL-NOS refractory to chemotherapy received mogamulizumab prior to allogeneic haematopoietic stem cell transplantation (allo-HSCT). Despite a 60-day washout period, he developed prolonged steroid-refractory acute graft-versus-host disease requiring ruxolitinib and extracorporeal photopheresis. Concurrently, transient skin lesions developed at previous lymphoma sites and regressed spontaneously, with biopsy supporting the interpretation of visible graft-versus-lymphoma. CONCLUSION: This case underscores the need to optimise allo-HSCT timing after mogamulizumab and preserve graft-versus-lymphoma effect while limiting graft-versus-host disease. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.