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

Research output: Contribution to journalArticle

48 Citations (Scopus)

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 - 1987
Externally publishedYes

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Interleukin-2
Kidney
Hypoalbuminemia
Hemodynamics
Sodium
Azotemia
Therapeutics
Hexosaminidases
Central Venous Pressure
Water-Electrolyte Balance
Lymphokines
Kidney Neoplasms
Septic Shock
Hematocrit
Renin
Hypotension
Weight Gain
Blood Vessels
Colorectal Neoplasms
Melanoma

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Renal, volume, and hormonal changes during therapeutic administration of recombinant interleukin-2 in man. / Textor, Stephen C; Margolin, Kim; Blayney, Douglas; Carlson, Janet; Doroshow, James.

In: The American journal of medicine, Vol. 83, No. 6, 1987, p. 1055-1061.

Research output: Contribution to journalArticle

Textor, Stephen C ; Margolin, Kim ; Blayney, Douglas ; Carlson, Janet ; Doroshow, James. / Renal, volume, and hormonal changes during therapeutic administration of recombinant interleukin-2 in man. In: The American journal of medicine. 1987 ; Vol. 83, No. 6. pp. 1055-1061.
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