Association of interleukin-2 therapy with staphylococcal bacteremia

Article Abstract:

Interleukin-2 plays a number of roles in the immune system, which include stimulating the proliferation of cytotoxic T cells and natural killer cells, and the generation of the lymphokine-activated killer cells. Since these cells can, under some circumstances, recognize and destroy tumor cells, it seems reasonable to evaluate interleukin-2 as a possible addition to the treatment regimens of cancer patients. Interleukin-2 is not without its adverse effects, which include fever, diarrhea, and liver and kidney dysfunction. Studies of the use of interleukin-2 in the treatment of cancer have also recorded an increase in the rate of bacterial infection, as well. Since such patients often receive drugs through continuous intravenous infusion, which in itself constitutes a high-risk of infection, or are involved with other invasive procedures, the infections of these patients could not be directly attributed to the interleukin-2 treatment. Now, however, a prospective study of patients undergoing leukapheresis indicates that interleukin-2 treatment is indeed associated with an increased risk of bacterial infection. In leukapheresis, a patient's blood is continuously drained, the white blood cells are removed, and the remaining plasma and cells are returned to the patient's circulation. The procedure is often used to obtain white blood cells from a patient in preparation for autologous bone marrow transplantation. In the present study, none of 16 patients undergoing leukapheresis for this reason developed any documented infection, despite the fact that catheters remained in their veins for an average of 20 days. However, among 17 patients receiving low-dose interleukin-2 as a part of an experimental cancer treatment, 3 cases of bacteremia developed. Three cases of bacteremia also developed among eight patients who were undergoing a similar procedure with a higher dose of interleukin-2. In all cases, species of the bacteria Staphylococcus were isolated and identified in the blood. The results indicate that interleukin-2 carries a dose-dependent risk of bacterial infection when used in current experimental treatment protocols. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Risk factors, Interleukins, Bacteremia, Staphylococcal infections

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Thyroid dysfunction associated with immunotherapy for patients with cancer

Article Abstract:

In recent years, many researchers have turned their attention to the immune system as a possible source of new therapies for cancer. Many cancer patients have been experimentally treated with interleukin-2, a lymphokine, which plays a key role in the killing of cancer cells by immune system T cells. For some cancers, such as melanoma and renal cell cancer, it has been reported that from 20 to 35 percent of the patients achieved significant regression of their tumors with interleukin-2 treatment. However, even interleukin-2, which is a natural part of the immune response, causes side effects when given in therapeutic doses. In a study of the responses of 130 cancer patients to interleukin-2 immunotherapy, researchers documented abnormalities of thyroid gland function in a significant fraction. The most commonly observed abnormality was hypothyroidism, a depression of the normal physiological responses of the thyroid gland. Hypothyroidism occurred in 38 percent of the patients during therapy and was present in 23 percent after immunotherapy was completed. It should be mentioned, however, that hypothyroidism is not uncommon, and was present in 12 percent of the patients prior to immunotherapy. The rate of hyperthyroidism, or excessive thyroid function, was less than that of hypothyroidism, but significant nonetheless. Hyperthyroidism developed in two percent of the patients during immunotherapeutic treatment and in six percent after treatment. The high rates of thyroid abnormalities in patients receiving interleukin-2 indicate that monitoring thyroid function should be a standard part of treatment for any patient receiving lymphokine as a part of cancer therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hypothyroidism, Thyroid gland, Hyperthyroidism

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Myocarditis or acute myocardial infarction associated with interleukin-2 therapy for cancer

Article Abstract:

There has been considerable interest in the use of so-called immune modulators in the treatment of cancer. In particular, interleukin-2 (IL-2) has received attention due to its ability to stimulate T cells which are responsible for mounting an immune response against specific cells. However, although IL-2 is a natural part of the body's immune response, the substance is not entirely safe and a death rate of about 1.5 percent is experienced when using the drug to treat cancer patients. The authors examined the hearts of eight patients who died following IL-2 treatment, and in this article they report on the pathological observations. Two patients were observed to have atherosclerosis, but it was also found that there was necrosis (tissue death) in the heart muscle of two patients who had no signs of atherosclerotic disease. This observation indicates that the profound reduction in blood pressure which may occur as a result of IL-2 treatment may deprive the heart muscle of adequate oxygen even in the absence of coronary artery disease. Noninfectious myocarditis (inflammation of the heart muscle) was observed in five patients, and it has been found that such myocarditis is not observed in patients who die more than four days after interleukin-2 treatment. This myocarditis is believed to contribute to the arrhythmias observed in patients undergoing IL-2 treatment. It is clear that patients on IL-2 therapy must be constantly monitored for cardiac arrhythmias and signs of heart failure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Heart attack, Cancer, Myocarditis

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