TY - JOUR
T1 - Renal, volume, and hormonal changes during therapeutic administration of recombinant interleukin-2 in man
AU - Textor, Stephen C.
AU - Margolin, Kim
AU - Blayney, Douglas
AU - Carlson, Janet
AU - Doroshow, James
N1 - Funding Information:
From the Departments of Consultative Medicine/ Nephrology and Medical Oncology, City of Hope National Medical Center, Duarte, California. These studies were supported in part by Cancer Center Core grant CA33572 and subcontract 21744-07-3 from the National Cancer Institute, Department of Health and Human Services. Portions of these results were presented at the American Society of Nephrology meeting in Washington D.C. on December 8, 1986. Requests for reprints should be addressed to Dr. Stephen C. Textor, Department of Consultative Medicine/Nephrology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, California 91010. Manuscript submitted January 23, 1987, and accepted July 27, 1987.
PY - 1987/12
Y1 - 1987/12
N2 - 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.
AB - 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.
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U2 - 10.1016/0002-9343(87)90941-7
DO - 10.1016/0002-9343(87)90941-7
M3 - Article
C2 - 3509745
AN - SCOPUS:0023614816
SN - 0002-9343
VL - 83
SP - 1055
EP - 1061
JO - The American Journal of Medicine
JF - The American Journal of Medicine
IS - 6
ER -