Does interleukin-2 have a role in the management of acute leukemia?
OBJECTIVE
To discuss the possibility that interleukin-2 (IL-2)-based immunotherapeutic protocols may have a role in the management of acute leukemia.


METHODS
The preclinical results that have led to the clinical use of IL-2 in acute leukemia will be reviewed. The clinical data obtained with the administration of IL-2 to acute leukemia patients in different phases of their disease will be discussed, together with the clinicohematologic and immunologic modifications induced following the infusion of IL-2. Finally, the possibility that limitations associated with the exogenous administration of high-dose IL-2 may be circumvented by engineering techniques aimed at inserting the IL-2 gene directly into the tumor cells, will be addressed.


RESULTS
The data indicate that high-dose IL-2 may be administered to acute leukemia patients. Toxicity, recorded in all patients, appears to be controllable using a continuous intravenous (i.v.) infusion protocol based on a daily dose-escalating administration. Complete remissions have been documented in acute myeloid leukemias (AMLs) with a limited, but detectable proportion of residual marrow blasts. Numerous phenotypic and functional changes have been recorded within the immune system of the host. Using retroviral vectors, the IL-2 gene may be productively transduced into human acute leukemia cell lines.


CONCLUSIONS
IL-2 appears to represent a therapeutic option for AML patients with limited/minimal residual disease. The results of the ongoing randomized trials in patients in first or second remission are awaited.
Foa
R
R
Dipartimento di Scienze Biomediche e Oncologia Umana, Sezione di Clinica Medica, Torino, Italy.
D000208:Acute Disease; D000818:Animals; D015316:Genetic Therapy / Q000379:methods; D006801:Humans; D007376:Interleukin-2 / Q000627:therapeutic use*; D007938:Leukemia / Q000188:drug therapy* / Q000628:therapy; D007942:Leukemia, Experimental / Q000188:drug therapy
D007376:Interleukin-2