{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:25:20Z","timestamp":1786123520330,"version":"build-2736575974"},"reference-count":6,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Protein\u2010losing enteropathy (PLE) is a rare but potentially severe complication of malignant lymphoma characterized by excessive gastrointestinal loss of plasma proteins, leading to hypoalbuminemia, edema, and serous effusions. We report a case of follicular lymphoma complicated by severe PLE and concomitant immune thrombocytopenia (ITP) without gastrointestinal involvement. A 51\u2010year\u2010old man presented with progressive hypoalbuminemia, refractory ascites, thrombocytopenia, and systemic lymphadenopathy. Initial treatment with rituximab monotherapy was selected due to low tumor burden and ITP, followed by rituximab plus lenalidomide (R2), but both resulted in only transient responses.\n                      <jats:sup>99m<\/jats:sup>\n                      Tc\u2010labeled human serum albumin scintigraphy confirmed the diagnosis of PLE. Mosunetuzumab was initiated as third\u2010line therapy. Serum albumin levels increased from 0.7\u00a0g\/dL to approximately 2.0\u00a0g\/dL, accompanied by marked improvement in ascites and edema. Platelet counts, which had initially been reduced to approximately 30,000\/\u00b5L, normalized after rituximab and further increased to 300,000\u2013500,000\/\u00b5L following mosunetuzumab. Complete remission was achieved and has been maintained for over four months at the time of writing. This case suggests that mosunetuzumab may effectively control both lymphoma\u2010associated PLE and immune\u2010mediated cytopenia through deeper and more sustained B\u2010cell depletion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The authors have confirmed clinical trial registration is not needed for this submission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jha2.70333","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:33:54Z","timestamp":1781872434000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mosunetuzumab Successfully Treated Rituximab\u2010Refractory Lymphoma\u2010Associated Protein\u2010Losing Enteropathy With Concomitant Immune Thrombocytopenia in Follicular Lymphoma: A Case Report"],"prefix":"10.1002","volume":"7","author":[{"given":"Takashi","family":"Matsunaga","sequence":"first","affiliation":[{"name":"Department of Hematology Kantoh Rosai Hospital  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohi","family":"Sahara","sequence":"additional","affiliation":[{"name":"Department of Hematology Kantoh Rosai Hospital  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Mizusawa","sequence":"additional","affiliation":[{"name":"Department of Hematology Kantoh Rosai Hospital  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Hematology Kantoh Rosai Hospital  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiichiro","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Hematology Kantoh Rosai Hospital  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Hematology Kantoh Rosai Hospital  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Oono","sequence":"additional","affiliation":[{"name":"Department of Hematology Kantoh Rosai Hospital  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S136803"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.8261\u201021"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.47.1189"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(22)00335\u20107"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201007\u20101254"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023022348"}],"container-title":["eJHaem"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70333","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jha2.70333","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70333","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:53:29Z","timestamp":1786114409000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jha2.70333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":6,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/jha2.70333"],"URL":"https:\/\/doi.org\/10.1002\/jha2.70333","archive":["Portico"],"relation":{},"ISSN":["2688-6146","2688-6146"],"issn-type":[{"value":"2688-6146","type":"print"},{"value":"2688-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70333"}}