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The influence of low dose recombinant interleukin-2 (rIL-2) therapy on immunological system of patients previously treated with purine analogues.Department of Haematooncology and Bone Marrow Transplantation Center, University Medical School in Lublin, PolandAIM: The aim of the study was to reconstitute the immune system in heavily suppressed patients previously treated with purine analogues, using very low dose of interleukin-2 (IL-2) and to correlate the effect of therapy with the incidence of infections. METHODS: We analyzed fourteen patients with B-cell proliferations, who previously received 3 to 9 cycles of chemotherapy based on 2-CdA or fludarabine. They displayed signs of infections and the amounts of CD4, CD8 and NK cells in the blood less than 400 cells in & microliter;(0,4 G/l). All patients received 1.8 x 106 IU of IL-2 daily, subcutaneously during two weeks. Patients received totally 3 cycles of a two-week IL-2 therapy. Before and after each IL-2 cycle we studied the expression of lymphocyte subpopulations and IL-2 receptors in the blood using flow cytometry technique. RESULTS: During IL-2 therapy we revealed continuous increase of CD4, CD8 and NK cells comparing to the amounts of these lymphocytes before IL-2 therapy. The increase of all lymphocyte subsets was already seen after first cycle of IL-2 and in case of CD4 lymphocytes and NK cells it reached statistical significance. After the end of IL-2 treatment we observed statistically significant increase of NK cells and close to significant increase of CD4 and CD8 lymphocytes. The increase of IL-2 receptors was marked but without statistical significance. In 50% of patients decreased incidence of infections was observed. The number of all infectious episodes after IL-2 therapy was about two times reduced, compared to 10 months period before IL-2 treatment. Low-dose IL-2 appeared as well tolerated therapy with severe side-effects seen only in two patients. CONCLUSION: It seems that IL-2 in a dose as low as 1.8 x 106 IU/day is sufficient to boost the immune response in immunodeficient patients. KEY WORDS: interleukin-2, immunotherapy, purine analogues. For more information, contact magdamal@hoga.pl Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Immunotherapy. |
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