title: Feasibility of high-dose interleukin-2 in heavily pretreated pediatric cancer patients.
abstract: BACKGROUND
  The administration of high-dose interleukin-2 (IL-2) seems to be a therapeutic option for children with refractory and metastatic solid malignancies.
  
  
  METHODS
  We prospectively studied treatment-related toxicities, quality of life and laboratory parameters in 10 children with progressive or metastatic solid tumors (metastatic osteosarcoma, n=4; neuroblastoma stage IV, n=3; metastatic Ewing's sarcoma, n=2; metastatic Wilms' tumor, n=1) during IL-2 therapy. Patients were scheduled to receive five cycles of high-dose IL-2 by continuous infusion for 5 days every 3 weeks.
  
  
  RESULTS
  All patients developed fever >39 degrees C and influenza-like symptoms, with a significant decrease in Karnofsky score. In two patients treatment had to be stopped after three cycles because of severe side-effects. During IL-2 therapy a statistical significant increase in white blood cells (WBC), creatinine, gamma-glutamyltransferase, C-reactive protein, glucose and body weight was observed. In contrast, red blood cells, platelets, protein, albumin and cholinesterase significantly decreased. When results from day 1 of the first and of the fifth cycle were compared, an increase of WBC and a decrease of alkaline phosphatase was shown. No constant quantitative changes in total lymphocytes and subsets were observed during IL-2 therapy.
  
  
  CONCLUSIONS
  IL-2 treatment in children with refractory and relapsed solid malignancies is associated with severe, but reversible, side-effects. However, five of the 10 patients with diseases of worst prognosis could be rescued by this treatment.
authors.affiliation: Division of Pediatric Haematology/Oncology, Department of Pediatrics Institute of Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria. wolfgang.schwinger@meduni-graz.at
authors.forename: W
authors.initials: W
authors.lastname: Schwinger
authors.forename: V
authors.initials: V
authors.lastname: Klass
authors.forename: M
authors.initials: M
authors.lastname: Benesch
authors.forename: H
authors.initials: H
authors.lastname: Lackner
authors.forename: H J
authors.initials: HJ
authors.lastname: Dornbusch
authors.forename: P
authors.initials: P
authors.lastname: Sovinz
authors.forename: A
authors.initials: A
authors.lastname: Moser
authors.forename: G
authors.initials: G
authors.lastname: Schwantzer
authors.forename: C
authors.initials: C
authors.lastname: Urban
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009369:Neoplasms / Q000145:classification / Q000188:drug therapy*
chemical_list: D007376:Interleukin-2