Immunomodulation in a treatment program including pre- and post-operative interleukin-2 and chemotherapy for childhood osteosarcoma.
OBJECTIVE
The treatment applied in our Institution to children with localized osteosarcoma between 1991 and 1999 consisted of four interleukin 2 (IL-2) courses (9 x 10(6) IU/mL/daily x 4), alternated with pre- and post-operative polichemotherapy. The aims of the present study were to quantify the modifications of some immunological parameters induced by IL-2 and to verify whether polychemotherapy could reduce them. An additional aim was to assess whether any correlation between the immune modifications and the clinical outcome could be found.


METHODS
We evaluated in 18 consecutive patients the following changes, induced in blood by each IL-2 course: number of lymphocyte subpopulations and natural killer (NK) cells, lymphokine activated killer (LAK) and NK activities.


RESULTS
Chemotherapy did not influence the modifications of the number of NK and CD4+ cells and of the LAK and NK activities, induced by each of the four courses of IL-2. The magnitudo of the NK activity and the peak of the NK absolute counts significantly correlated with the clinical outcome.


CONCLUSIONS
The results show that the use of IL-2 permitted a repeated immune activation despite the intensive chemotherapy. Furthermore, although the limited number of cases precludes any definitive conclusion, the results suggest a possible role of the NK cells in the control of osteosarcoma.
Luksch
Roberto
R
Department of Medical Oncology, Pediatric Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy. luksch@istitutotumori.mi.it
Perotti
Daniela
D
Cefalo
Graziella
G
Gambacorti Passerini
Carlo
C
Massimino
Maura
M
Spreafico
Filippo
F
Casanova
Michela
M
Ferrari
Andrea
A
Terenziani
Monica
M
Polastri
Daniela
D
Gambirasio
Felicita
F
Podda
Marta
M
Bozzi
Fabio
F
Ravagnani
Fabrizio
F
Parmiani
Giorgio
G
Fossati Bellani
Franca
F
D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D002648:Child; D015331:Cohort Studies; D003602:Cytotoxicity, Immunologic / Q000187:drug effects; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007376:Interleukin-2 / Q000627:therapeutic use*; D015979:Killer Cells, Lymphokine-Activated / Q000187:drug effects* / Q000276:immunology; D007694:Killer Cells, Natural / Q000187:drug effects* / Q000276:immunology; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D012516:Osteosarcoma / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D011184:Postoperative Period; D011300:Preoperative Care; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D016896:Treatment Outcome; D014407:Tumor Cells, Cultured / Q000276:immunology
D000970:Antineoplastic Agents; D007376:Interleukin-2