Correlation of serum cytokine and acute phase reactant levels with alterations in weight and serum albumin in patients receiving immunotherapy with recombinant IL-2

Clin Exp Immunol. 1994 Mar;95(3):366-72. doi: 10.1111/j.1365-2249.1994.tb07005.x.

Abstract

Recombinant IL-2 (rIL-2) has been used alone or in combination with other chemotherapeutic agents to enhance host defences against cancer. Prolonged administration of high doses, required for clinical efficacy, may precipitate serious dose-limiting toxicity. rIL-2-induced 'vascular leak syndrome' leads to hypotension, renal insufficiency, respiratory disturbances and other organ dysfunctions. Serial measurements of serum cytokines and the acute phase protein C-reactive protein (CRP) were performed on nine patients who received high-dose i.v. continuous therapy with rIL-2. The influence of these immunological parameters upon alterations in patients' weight and serum albumin, as indicators of toxicity, was assessed. All patients experienced weight increases during the cycle (3-11% of total body weight). The serum levels of tumour necrosis factor (TNF-alpha) and CRP were highly predictive of alterations in patients' weight (both P < 0.001), while no correlation was found with IL-6 and weight change. Serum albumin fell linearly throughout the infusion cycle, but this showed no correlation with variations in serum levels of IL-6, TNF-alpha, or CRP. The complement components C3 and C4 were significantly reduced at the end of the infusion, suggesting a possible role for this cascade system in mediating these clinical changes. The strong association between serum TNF-alpha and weight change, not previously documented, further supports the hypothesis that TNF-alpha is a key mediator in the pathogenesis of the 'vascular leak syndrome'.

MeSH terms

  • Acute-Phase Proteins / analysis
  • Body Weight
  • C-Reactive Protein / analysis
  • Carcinoma / drug therapy*
  • Colorectal Neoplasms / drug therapy*
  • Complement System Proteins / analysis
  • Cytokines / blood
  • Humans
  • Immunotherapy
  • Infusions, Intravenous
  • Interleukin-2 / adverse effects
  • Interleukin-2 / therapeutic use*
  • Interleukin-6 / blood
  • Predictive Value of Tests
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / therapeutic use
  • Serum Albumin / analysis
  • Tumor Necrosis Factor-alpha / analysis

Substances

  • Acute-Phase Proteins
  • Cytokines
  • Interleukin-2
  • Interleukin-6
  • Recombinant Proteins
  • Serum Albumin
  • Tumor Necrosis Factor-alpha
  • Complement System Proteins
  • C-Reactive Protein