interleukin 2 side effects + patient report

Possible side effects of Interleukin-2

• Fevers and chills
• Itching and rash
• Flu-like symptoms like headache, tiredness, aches and pains

Full Answer

What are the possible adverse effects of interleukin 2 (IL-2) toxicity?

Chills, fever, and malaise are among the most common and predictable adverse events associated with high-dose IL-2. Typically, chills develop within 1 to 2 hours of the first or second dose and are treated with repeated doses of meperidine and warm blankets. [8]

What are the side effects of too much IL-2?

In other words, high doses may produce more severe side effects. In some cases, this could necessitate hospitalization and/or intensive care unit support. The following are common (occurring in greater than 30%) side effects for patients taking IL-2: Fever and chills or flu-like symptoms.

What type of drug is Interleukin-2?

Drug type : Interleukin-2 is a "biologic response modifier." Interleukin-2 is classified as a "cytokine." (For more detail, see "How this drug works" section below). Cancers treated with Interleukin-2 include renal cell (kidney) and melanoma, a skin cancer.

Is Interleukin-2 therapy for renal cell carcinoma safe?

Interleukin-2 (IL-2) therapy has been used with success in curing meta­static renal cell carcinoma and melanoma in a small minority of patients. However, the benefits can be accompanied by severe toxicity. This review of the literature discusses varying doses of IL-2 and their associated re­sponse rates and the toxicities associated with treatment.

What are the side effects of interleukin-2?

Side effects of IL-2 can include flu-like symptoms such as chills, fever, fatigue, and confusion. Some have nausea, vomiting, or diarrhea. Many people develop low blood pressure, which can be treated with other medicines.

What are the potential risks of interleukins?

The following are less common (occurring in 10 to 29%) side effects for patients taking Interleukin-2:Respiratory congestion or breathing difficulty (see lung problems).Itching.Low blood counts (low white blood cells)Mouth sores.Poor appetite.Fatigue.Weight gain or loss.Infection.More items...

Is IL-2 cancer treatment toxic?

IL-2 toxicity can manifest in multiple organ systems, most significantly the heart, lungs, kidneys, and central nervous system. The most common manifestation of IL-2 toxicity is capillary leak syndrome, resulting in a hypovolemic state and fluid accumulation in the extravascular space.

Why is IL-2 toxic?

We also find that IL-2 induced toxicity is mediated through human T cells, and is associated with decreased Treg homeostasis and function in HIS mice.

What is a side effect of interleukin treatment?

Infusion Related Side Effects The interleukin-2 infusion (the high dose regimen) can cause a reaction that may include low blood pressure, increased heart rate or arrhythmias, shortness of breath, rash, nausea, diarrhea and joint and muscle stiffness.

What is the role of interleukin-2?

Interleukin-2 is made by a type of T lymphocyte. It increases the growth and activity of other T lymphocytes and B lymphocytes, and affects the development of the immune system.

Is Interleukin 2 FDA approved?

High-dose bolus interleukin-2 (IL-2) was granted US Food and Drug Administration (FDA) approval in 1992 based on its ability to produce durable complete responses (CRs) in a small number of patients. Unfortunately, the toxicity, expense, and restricted accessibility of high-dose IL-2 make it a poor standard therapy.

How much does interleukin 2 cost?

CHIRON/CETUS' PROLEUKIN (IL-2) THERAPY WILL COST $6,000-$8,000 PER COURSE, based on the average use of 30-35 vials per therapeutic cycle for adults with metastatic renal cell carcinoma, Chiron said May 5 following FDA's approval of human recombinant interleukin-2 (aldesleukin).

Can cytokines cure cancer?

Potentiating the immune response. Pro-inflammatory cytokines can contribute to cancer immunotherapy, acting on every phase of the cancer immunity cycle. Thus, cytokines can improve antigen priming, increase the number of effector immune cells in the TME and enhance their cytolytic activity.

What is Interleukin used for?

Interleukins regulate immune responses. Interleukins made in the laboratory are used as biological response modifiers to boost the immune system in cancer therapy. An interleukin is a type of cytokine. Also called IL.

What medications cause cytokine release syndrome?

CRS can be triggered by infections or be associated with drugs such as monoclonal antibodies (e.g., rituximab), conventional chemotherapy, and immunotherapies with chimeric antigen receptor T (CAR T) cells (Shimabukuro-Vornhagen et al., 2018).

What is cytokine release syndrome?

(SY-toh-kine reh-LEES SIN-drome) A condition that may occur after treatment with some types of immunotherapy, such as monoclonal antibodies and CAR-T cells. Cytokine release syndrome is caused by a large, rapid release of cytokines into the blood from immune cells affected by the immunotherapy.

What is Interleukin-2?

Interleukin-2 (also known as Aldesleukin and IL-2) is similar to a natural substance made by the body. Usually, the body makes small amounts of interleukin-2 that help white blood cells fight infection. It is now possible to make interleukin-2 outside the body and to give humans much higher doses than their own bodies make. It is available as a clear liquid given by vein (IV) or as a subcutaneous (under the skin) injection.

How long does Interleukin 2 last?

Interleukin-2 has a short expiration period when made by the pharmacy. You must return to the Outpatient Pharmacy to pick up any remaining doses for each cycle (up to 6 doses per cycle). Refer to “ Do You Know... How to Give Subcutaneous Injections ” for details on how to give a dose.

What are the side effects of a syringe?

Loss of appetite. Decrease in the amount of urine. Weight gain. Anemia. Low blood pressure. These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse. In case of a severe side effect or reaction, call your doctor, nurse, or pharmacist at 901-595-3300.

Where to store Interleukin 2?

Special instructions for Interleukin-2. Interleukin-2 syringes should be stored in the refrigerator. Pay close attention to the expiration date written on the label. Check with your doctor before starting any new medicines, including over-the-counter, natural products, or vitamins.

Can you give interleukin 2 injections?

It is now possible to make interleukin-2 outside the body and to give humans much higher doses than their own bodies make. It is available as a clear liquid given by vein (IV) or as a subcutaneous (under the skin) injection.

What organ system is affected by IL-2?

IL-2 toxicity can manifest in multiple organ systems, most significantly the heart, lungs, kidneys, and central nervous system . The most common manifestation of IL-2 toxicity is capillary leak syndrome, resulting in a hypovolemic state and fluid accumulation in the extravascular space.

Is IL-2 toxic?

High-dose IL-2 is associated with significant morbidity; however, the incidence and severity of toxicities have decreased as clinicians have gained experience with this agent and implemented toxicity prevention and management strategies. IL-2 toxicity can manifest in multiple organ systems, most significantly the heart, lungs, kidneys, ...

Is interleukin 2 toxic?

Managing toxicities of high-dose interleukin-2. Although high-dose interleukin-2 (IL-2, Proleukin), a highly toxic agent used in the treatment of renal cell carcinoma and melanoma, was initially associated with treatment-related mortality, it can, in the appropriate setting, be administered safely.

What are the side effects of IL-2?

The following are common (occurring in greater than 30%) side effects for patients taking IL-2: Fever and chills or flu-like symptoms. The severity decreases over time, particularly in low-dose regimens. Generalized flushing (redness) of the face and body, or skin rash.

What is the drug type of IL-2?

Drug type : IL-2 is a "biologic response modifier." IL-2 is classified as a "cytokine." (For more detail, see "How this drug works" section below).

What is the trade name for IL-2?

IL-2. Generic name: Aldesleukin. Trade name: Proleukin ®. Other names: Interleukin-2. Proleukin ® is the trade name for the generic drug name Aldesleukin. IL-2 and Interleukin-2 are other names for Aldesleukin. In some cases, health care professionals may use the trade name Proleukin ® or other names IL-2 and Interleukin-2 when referring to ...

What are the symptoms of capillary leak syndrome?

Capillary leak syndrome is characterized by the presence of 2 or more of the following 3 symptoms; low blood pressure, swelling, and low levels of protein in the blood.

How many episodes of vomiting in 24 hours?

Nausea that interferes with eating and is not relieved by medications prescribed by your doctor. Vomiting (more than 4 to 5 episodes within a 24-hour period).

How often is IL-2 given?

The high-dose regimen involves giving the drug intravenously (into a vein) every eight hours, as tolerated, for up to 15 doses.

What happens if your blood count is low?

Your white and red blood cells and platelets may temporarily decrease in number. This can put you at increased risk for infection, anemia and/or bleeding.

What are the toxicities of IL-2?

IL-2 administration causes a broad range of cardiopulmonary toxicities, with hypotension, tachycardia, and dyspnea being the most common. [1] Hypotension and tachycardia often develop within 2 hours of the first dose, progressing in severity as therapy continues. [8] Hypotension usually reverses within 48 hours after IL-2 discontinuation. [8] The results of early clinical trials show that high-dose IL-2 produced grade 3/4 hypotension requiring vasopressor support in up to 81% of patients. [5] A more recent study shows that only 31% of patients required vasopressor support.

How long does it take to take IL-2?

Based on the results of clinical trials and practical experiences, a two-cycle course of high-dose IL-2 administered intravenously (IV) is standard. Each course consists of two 5-day cycles (600,000 IU/kg/dose administered IV over 15 minutes q8h) separated by a minimum of 9 days. If tolerated, IL-2 is given for a maximum of 14 doses per cycle and 28 doses per course. [1] Higher dosages have not been associated with improved response rates or survival times. [7] Courses of therapy are separated by at least 7 weeks after hospital discharge and should only be repeated if the results of restaging studies demonstrate tumor responsiveness or stabilization. [1,8]

What is the best solution for IL-2?

The results of one trial suggested that crystalloid and colloidal solutions are equally effective for replacing intravascular volume, but the lower cost of crystalloid solutions made it the fluid of choice. [18] Colloidal solutions, however, are still advocated by some clinicians to maximize intravascular volume. [10] Vasopressor support with phenylephrine is a very effective treatment for IL-2-induced hypotension, but generally requires administration in an intensive care unit. Doses of phenylephrine greater than 2.5 µg/kg/min are rarely needed. [11] Vasopressor support with dopamine is not recommended because this agent may precipitate arrhythmias if doses greater than 5 µg/kg/min are used; however, low-dose dopamine, 2 to 5 µg/kg/min, is often given before or concomitantly with phenylephrine to improve renal perfusion and urine output. [8,10,11]

How long does it take for IL-2 to reverse?

[8] Hypotension usually reverses within 48 hours after IL-2 discontinuation. [8] The results of early clinical trials show that high-dose IL-2 produced grade 3/4 hypotension requiring vasopressor support in up to 81% of patients. [5] A more recent study shows that only 31% of patients required vasopressor support.

Why do I get fever after IL-2?

Although steroids can block the induction of TNF-a, their use is contraindicated during IL-2 therapy because steroids block immune system activation and IL-2 antitumor activity. [10] Further, as fever is commonly observed in patients receiving high-dose IL-2, it is most effectively prevented and managed with antipyretics before and during therapy. Administering acetaminophen before the first IL-2 dose and every 4 hours until 24 hours after the last IL-2 dose within a cycle is universally advocated. [8,10] The addition of a nonsteroidal anti-inflammatory drug (NSAID), such as indomethacin, to this antipyretic regimen has also been advocated. [8,10] Other clinicians believe that NSAIDs should be used with caution because of their potential to exacerbate gastritis and further impair renal blood flow in patients with renal manifestations of capillary leak syndrome. [15] Malignant hyperthermia related to IL-2 therapy has been associated with one death. [8]

How long does it take for a chill to develop after taking IL-2?

Chills, fever, and malaise are among the most common and predictable adverse events associated with high-dose IL-2. Typically, chills develop within 1 to 2 hours of the first or second dose and are treated with repeated doses of meperidine and warm blankets.

How does IL-2 cause capillary leak syndrome?

IL-2 toxicity is mediated through lymphoid infiltration, a well-described capillary leak syndrome, and the local effects of secondary cytokines. [8] The complex mechanism of action whereby IL-2 induces capillary leak syndrome is postulated to involve a series of steps, including induction of circulating cytokines, such as tumor necrosis factor-alfa (TNF-a) and other interleukins; generation of complement-activation products; neutrophil activation; and activation of endothelial-cell antigens. [8] After IL-2 administration, induced cytokines are released, leading to increased capillary permeability and decreased vascular resistance, which results in a shift of fluid from the bloodstream into the extravascular space. This fluid shift ultimately leads to a hypovolemic state and excessive fluid in the extravascular space. Capillary leak syndrome-associated fluid accumulation in the extravascular spaces may manifest as generalized edema, weight gain, pulmonary congestion, pleural effusions, and ascites. [8] Capillary leak syndrome-associated hypovolemia may cause decreased blood flow to the kidneys, gut, heart, and brain, resulting in oliguria, ischemia, and confusion. Usually, capillary leak syndrome affects more than one organ system simultaneously, contributing to the toxicity often observed in patients receiving high-dose IL-2. The release of cytokines after IL-2 administration has also been implicated as the cause of flu-like symptoms, such as fever, chills, myalgias, and arthralgias.

What Is Interleukin-2?

How Interleukin-2 Is Given

Possible Side Effects of Interleukin-2

• Early 1. Fevers and chills 2. Itching and rash 3. Flu-like symptoms like headache, tiredness, aches and pains Later (more than a day after treatment starts) 1. Diarrhea 2. Nausea or vomiting 3. Feeling tired or weak 4. Feeling lightheaded or dizzy 5. Fainting spells 6. Blurred vision 7. Loss of appetite 8. Decrease in the amount of urine 9. Weight ...

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Special Instructions For Interleukin-2