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Renal, volume, and hormonal changes during therapeutic administration of recombinant interleukin-2 in man

1987; Elsevier BV; Volume: 83; Issue: 6 Linguagem: Inglês

10.1016/0002-9343(87)90941-7

1555-7162

Stephen C. Textor, Kim Margolin, Douglas W. Blayney, Janet F. Carlson, James Doroshow,

Cancer, Stress, Anesthesia, and Immune Response

Changes in blood pressure, renal function, and fluid balance were studied in 12 patients receiving intravenous recombinant interleukin-2 (IL-2) (100,000 units/kg every eight hours) over five days for treatment of metastatic melanoma and renal and colorectal cancers. The IL-2 regimen produced progressive hypotension, azotemia, and sodium avidity (fractional excretion of sodium = 0.20 ± 0.07 percent) despite massive fluid administration (mean: 18.4 liter per five days) and weight gain (mean: 4.0 kg). Plasma renin activity rose. Hypoalbuminemia developed rapidly (3.6 ± 0.1 g/dl to 2.2 ± 0.1 g/dl, p <0.01) with widespread edema formation despite normal central venous pressures. Hematocrit did not change during the IL-2 period, consistent with a “capillary-leak.” Hemodynamic and renal functional changes reversed after the IL-2 regimen was discontinued, but hypoalbuminemia and elevated urinary n-acetyl-glucosaminidase levels persisted after six days. These studies demonstrate widespread hemodynamic and vascular effects of IL-2 administration that limit its safe use and suggest a possible role for the lymphokine in mediating cardiovascular instability under other circumstances, such as endotoxic shock.