Determination of capillary leakage due to recombinant interleukin-2 by means of noninvasive conductivity measurements.
One of the most common side effects of treatment with recombinant interleukin-2 (IL-2) is capillary leakage. Its genesis is not completely understood. The aim of the study was to determine whether capillary leakage can be monitored by means of a noninvasive conductivity technique and to study its starting point. Eight patients with advanced renal cell cancer were studied in a medium care section of the Department of Medical Oncology, University Hospital over 4 days during treatment sessions of continuous, intravenously administered IL-2 (mean dose of 15.6 x 10(6) IU.m-2.day-1). The fluid shift from the intravascular to the extra- and intracellular compartments was monitored by means of noninvasive conductivity measurements. Changes in blood volume were calculated from serial erythrocyte counts. The clinical parameters of capillary leakage (oliguria, positive fluid balance, and gain in mass) were recorded. The mean gain in mass was 9% after 4 days of IL-2 treatment. The extracellular fluid volume increased significantly [46 (SD 23.2)%; P < 0.01], whereas the intracellular fluid volume did not change. The increase in blood volume (BV) amounted to 7% (P < 0.05). The decline in albumin concentration was significantly more than the increase in BV [38 (SD 4.3)%; P < 0.01], indicating capillary albumin leakage. The main changes were observed after the 2nd day of treatment. From this study, it is suggested that conductivity measurements are a suitable method to monitor capillary leakage induced by IL-2, and could be used to detect the exact onset and severity of this leakage.(ABSTRACT TRUNCATED AT 250 WORDS)
Olthof
C G
CG
Department of Anaesthesiology, Free University Hospital, Amsterdam, The Netherlands.
Baars
J W
JW
Wagstaff
J
J
Donker
A J
AJ
Schneider
H
H
de Vries
P M
PM
D000328:Adult; D000368:Aged; D000418:Albumins / Q000378:metabolism; D001810:Blood Volume / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002199:Capillary Permeability / Q000187:drug effects*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000503:physiopathology; D004553:Electric Conductivity / Q000187:drug effects; D004562:Electrocardiography; D004906:Erythrocyte Count; D005110:Extracellular Space / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D007376:Interleukin-2 / Q000009:adverse effects* / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use
D000418:Albumins; D007376:Interleukin-2; D011994:Recombinant Proteins