Prevention by L-carnitine of interleukin-2 related cardiac toxicity during cancer immunotherapy.
OBJECTIVE
Cardiac toxicity has been observed during IL-2 cancer immunotherapy. Because of its trophic action on the myocardial tissue, the use of L-carnitine has been evaluated during IL-2 therapy in advanced cancer patients with clinically important cardiac diseases.


METHODS
The study included 30 cancer patients, who were randomized to treatment with IL-2 alone or IL-2 plus L-carnitine (1000 mg/day orally). IL-2 was injected subcutaneously at a daily dose of 6 million IU for 5 days/week for 4-6 weeks.


RESULTS
The percentage of cardiac complications was significantly lower in patients concomitantly treated with L-carnitine than those receiving IL-2 alone (0/15 vs 4/15; P < 0.05), whereas no difference was seen in mean creatine phosphokinase levels on study.


CONCLUSIONS
The results would suggest that L-carnitine may be used successfully to prevent cardiac complications during IL-2 immunotherapy in cancer patients with clinically relevant cardiac disorders. Since cardiac metabolism depends mainly on fatty acid oxidation, the stimulatory role of L-carnitine on fatty acid oxidation could explain at least in part its ability to prevent heart disturbances in response to IL-2 administration.
Lissoni
P
P
Division of Radiation Oncology, San Gerardo Hospital, Monza, Milan, Italy.
Galli
M A
MA
Tancini
G
G
Barni
S
S
D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000517:prevention & control; D002331:Carnitine / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D007376:Interleukin-2 / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*
D007376:Interleukin-2; D002331:Carnitine