Reduced CC chemokine receptor 4 expression after lenalidomide treatment for adult T-cell leukemia/lymphoma: a case report

Abstract

Abstract Background CC chemokine receptor 4 (CCR4), a chemokine receptor involved in leukocyte migration, is expressed in most tumor cells in patients with adult T-cell leukemia/lymphoma (ATLL). Recent years, an anti-CCR4 monoclonal antibody is one of the newly developed treatment options of ATLL. Therefore CCR4 expression is important for clinical decision making in ATLL. Case presentation We report a 78-year-old man diagnosed with lymphoma type ATLL, which expressed CCR4. The patient was administered two cycles of lenalidomide but died due to sepsis five months after the diagnosis. On autopsy, ATLL cells were found at several sites, including mediastinal lymph nodes and spleen. Immunohistochemical analysis revealed that these ATLL cells had reduced CCR4 expression although the expression levels of other markers were unchanged, suggesting that CCR4 expression on ATLL cells reduced after lenalidomide use. Conclusions Our patient suggests that treatment should be carefully determined in ATLL with reference to a history of lenalidomide use and CCR4 expression.