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Interleukin-2 therapy after bone marrow or stem cell transplantation for hematologic malignancies.

AbstractPURPOSE:
Autologous or allogeneic bone marrow transplantation (BMT) or stem cell transplantation (SCT) for advanced hematologic malignancies is associated with a high relapse rate. It has been postulated that recombinant interleukin-2 (rIL-2) administered as consolidative immunotherapy early after BMT or SCT, at a time of minimal residual disease, might reduce the relapse rate. We review here preliminary results from a series of studies designed to investigate the safety, immunomodulatory effects, and clinical benefits of rIL-2 therapy following autologous and allogeneic BMT and SCT.
PATIENTS AND METHODS:
Patients with hematologic malignancies underwent autologous or allogeneic BMT or SCT and received rIL-2 by continuous intravenous infusion a median of 33 to 56 days later. In all trials, the rIL-2 regimen consisted of a moderate induction dose for 4 to 5 days in the hospital, 4 to 6 days of rest, and a low maintenance dose for 10 days in the outpatient setting. A phase I trial of Roche rIL-2 after autoBMT, a feasibility trial of autologous lymphokine-activated killer cells with rIL-2, and another phase I/II trial of Chiron rIL-2 after autoBMT were performed. A similar phase I trial of IL-2 after alloBMT was also performed in children with acute leukemia beyond first complete remission.
RESULTS:
An rIL-2 regimen has been identified that can be tolerated early after transplantation. Administration of this rIL-2 regimen induces marked increases in CD3+CD8+ T lymphocytes and CD3-CD56+ natural killer cells and enhances their antitumor cytolytic activity. Encouraging but somewhat inconsistent clinical outcomes were noted in phase I/II trials in patients with lymphoma and acute myeloid leukemia.
CONCLUSIONS:
The results of phase I/II trials are sufficiently encouraging to justify prospectively randomized phase III trials to determine whether rIL-2 after autologous SCT will reduce the rate of posttransplantation relapse and improve survival in patients with advanced hematologic malignancies.
AuthorsA Fefer, N Robinson, M C Benyunes, W I Bensinger, O Press, J A Thompson, C Lindgren
JournalThe cancer journal from Scientific American (Cancer J Sci Am) Vol. 3 Suppl 1 Pg. S48-53 (Dec 1997) ISSN: 1081-4442 [Print] United States
PMID9457394 (Publication Type: Clinical Trial, Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Interleukin-2
  • Recombinant Proteins
Topics
  • Adolescent
  • Adult
  • Bone Marrow Transplantation
  • Child
  • Child, Preschool
  • Hematologic Neoplasms (mortality, therapy)
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunotherapy
  • Infant
  • Injections, Intravenous
  • Interleukin-2 (administration & dosage, therapeutic use)
  • Recombinant Proteins (therapeutic use)
  • Survival Rate
  • Treatment Outcome

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