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Annals of Oncology Advance Access originally published online on April 22, 2005
Annals of Oncology 2005 16(7):1199-1206; doi:10.1093/annonc/mdi226
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© 2005 European Society for Medical Oncology

Feasibility of high-dose interleukin-2 in heavily pretreated pediatric cancer patients

W. Schwinger1,*, V. Klass1, M. Benesch1, H. Lackner1, H. J. Dornbusch1, P. Sovinz1, A. Moser1, G. Schwantzer2 and C. Urban1

1 Division of Pediatric Haematology/Oncology, Department of Pediatrics 2 Institute of Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria

* Correspondence to: Dr W. Schwinger, Division of Pediatric Haematology/Oncology, Department of Pediatrics, Medical University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria. Tel: +43-316-385-83329; Fax: +43-316-385-3450; wolfgang.schwinger{at}meduni-graz.at

Background:: The administration of high-dose interleukin-2 (IL-2) seems to be a therapeutic option for children with refractory and metastatic solid malignancies.

Methods:: We prospectively studied treatment-related toxicities, quality of life and laboratory parameters in 10 children with progressive or metastatic solid tumors (metastatic osteosarcoma, n=4; neuroblastoma stage IV, n=3; metastatic Ewing's sarcoma, n=2; metastatic Wilms' tumor, n=1) during IL-2 therapy. Patients were scheduled to receive five cycles of high-dose IL-2 by continuous infusion for 5 days every 3 weeks.

Results:: All patients developed fever >39°C and influenza-like symptoms, with a significant decrease in Karnofsky score. In two patients treatment had to be stopped after three cycles because of severe side-effects. During IL-2 therapy a statistical significant increase in white blood cells (WBC), creatinine, {gamma}-glutamyltransferase, C-reactive protein, glucose and body weight was observed. In contrast, red blood cells, platelets, protein, albumin and cholinesterase significantly decreased. When results from day 1 of the first and of the fifth cycle were compared, an increase of WBC and a decrease of alkaline phosphatase was shown. No constant quantitative changes in total lymphocytes and subsets were observed during IL-2 therapy.

Conclusions:: IL-2 treatment in children with refractory and relapsed solid malignancies is associated with severe, but reversible, side-effects. However, five of the 10 patients with diseases of worst prognosis could be rescued by this treatment.

Key words: cancer, children, interleukin-2, side-effects, toxicity


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