Interleukin-2 for the treatment of advanced acute myelogenous leukemia patients with limited disease: updated experience with 20 cases.
Since 1988 we have treated a first group of 14 patients with recombinant interleukin-2 (rIL-2), which was previously published, and 6 other consecutive patients affected by refractory or relapsed acute myelogenous leukemia (AML) with >5% and < or = 30% bone marrow blasts, but not suitable for further chemotherapy. The rIL-2 schedule consisted of four 5-day high-dose cycles administered by continuous infusion with a 72-hour rest period between each cycle. Patients who achieved a response received a lower dose of subcutaneous rIL-2 maintenance treatment administered for 5 days every month. Following high-dose rIL-2, 11/20 patients (55%) obtained a complete remission (CR). Six remain in persistent CR after a median follow-up time of 50 months (9, 33, 49, 51, 52, 87 months, respectively); the length of remission is the longest in the natural history of the disease for each individual patient. One patient with stable disease at the end of rIL-2 induction is alive and well, with a stable number of blasts in the bone marrow, 18 months later. These 7 patients continue maintenance treatment with subcutaneous rIL-2. Close clinical and laboratory monitoring reveal that side effects are acceptable and no toxic deaths have been recorded. This update confirms the feasibility and antileukemic activity of high dose rIL-2 in advanced AML patients with limited disease, and suggests a potential clinical role of prolonged rIL-2 maintenance treatment.
Meloni
G
G
Hematology, Department of Human Biopatology, University "La Sapienza", Roma, Italy.
Vignetti
M
M
Andrizzi
C
C
Capria
S
S
Foa
R
R
Mandelli
F
F
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D005334:Fever / Q000139:chemically induced; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D007376:Interleukin-2 / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009846:Oliguria / Q000139:chemically induced; D011994:Recombinant Proteins / Q000627:therapeutic use; D016879:Salvage Therapy; D016896:Treatment Outcome
D007155:Immunologic Factors; D007376:Interleukin-2; D011994:Recombinant Proteins