Renal, volume, and hormonal changes during therapeutic administration of recombinant interleukin-2 in man

Stephen C. Textor, Kim Margolin, Douglas Blayney, Janet Carlson, James Doroshow

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Abstract

Changes in blood pressure, renal function, and fluid balance were studied in 12 patients receiving intravenous recombinant interleukin-2 (IL-2) (100,000 units/kg every eight hours) over five days for treatment of metastatic melanoma and renal and colorectal cancers. The IL-2 regimen produced progressive hypotension, azotemia, and sodium avidity (fractional excretion of sodium = 0.20 ± 0.07 percent) despite massive fluid administration (mean: 18.4 liter per five days) and weight gain (mean: 4.0 kg). Plasma renin activity rose. Hypoalbuminemia developed rapidly (3.6 ± 0.1 g/dl to 2.2 ± 0.1 g/dl, p <0.01) with widespread edema formation despite normal central venous pressures. Hematocrit did not change during the IL-2 period, consistent with a "capillary-leak." Hemodynamic and renal functional changes reversed after the IL-2 regimen was discontinued, but hypoalbuminemia and elevated urinary n-acetyl-glucosaminidase levels persisted after six days. These studies demonstrate widespread hemodynamic and vascular effects of IL-2 administration that limit its safe use and suggest a possible role for the lymphokine in mediating cardiovascular instability under other circumstances, such as endotoxic shock.

Original languageEnglish (US)
Pages (from-to)1055-1061
Number of pages7
JournalThe American Journal of Medicine
Volume83
Issue number6
DOIs
StatePublished - Dec 1987

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ASJC Scopus subject areas

  • Medicine(all)

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