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Mogamulizumab Concentration-guided Allogeneic Transplantation and Successful Intrathecal Chemotherapy for Central

Saki Fujii1, Kazuki Sakatoku1, Yosuke Nakaya1

  • 1Department of Hematology, Osaka Metropolitan University, Graduate School of Medicine, Japan.

Internal Medicine (Tokyo, Japan)
|October 22, 2025
PubMed

Adult T-cell leukemia/lymphoma (ATL) has a poor prognosis, with mogamulizumab effectively controlling the disease but increasing graft-versus-host disease (GVHD) risk during transplantation if residual levels persist. We herein report a 61-year-old patient with acute-type ATL who underwent mogamulizumab concentration-guided transplantation to avoid severe GVHD despite human leukocyte antigen-mismatched donor transplantation. Post-transplant central nervous system (CNS) relapse was successfully managed with intrathecal chemotherapy alone, achieving long-term remission. Two years post-transplantation, the patient remains in complete remission without relapse or chronic GVHD. This case highlights the importance of assessing mogamulizumab levels for optimal transplantation timing and intrathecal chemotherapy as a strategy for CNS-limited ATL relapse.

Keywords:
adult T-cell leukemiacentral nervous systemintrathecal chemotherapymogamulizumabrelapse

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