TY - JOUR
T1 - Colonic ischemia complicating immunotherapy with interleukin‐2 and interferon‐alpha
AU - Sparano, Joseph A.
AU - Dutcher, Janice P.
AU - Kaleya, Ronald
AU - Caliendo, Geralyn
AU - Fiorito, Joseph
AU - Mitsudo, Sumi
AU - Shechner, Richard
AU - Boley, Scott J.
AU - Gucalp, Rasim
AU - Ciobanu, Niculae
AU - Grima, Kathleen
AU - Wiernik, Peter H.
AU - Brandt, Lawrence J.
PY - 1991/10/1
Y1 - 1991/10/1
N2 - Colonic ischemia (CI) is a rare complication of high‐dose interleukin‐2 (IL‐2) immunotherapy. This complication occurred in three of 141 patients (2.1%) with metastatic cancer treated with high‐dose IL‐2 therapy; CI only developed in patients receiving interferon‐alpha (IFN) with IL‐2 (three of 21, 14%) compared with none of 120 in those patients receiving IL‐2 alone (P equals 0.0009). Severe diarrhea (≧ 7 bowel movements/day) also was significantly more common in patients receiving IFN with IL‐2 (six of 21, 29%) than in those receiving IL‐2 alone (three of 120, 2.5%, P equals 0.001) and preceded the clinical diagnosis of CI in all three patients. Three of nine patients with severe diarrhea had CI. Hematochezia occurred in four patients, all of whom received IFN with IL‐2; three had CI, and the other patient had nonspecific colitis. Differences in vasopressor use did not explain the increased risk of CI in patients receiving IFN; those receiving IFN with IL‐2 required phenylephrine less often than patients receiving IL‐2 alone (P equals 0.01). The administration of lymphokine‐activated killer (LAK) cells had no significant effect on the incidence of CI, severe diarrhea, peritonitis, or vasopressor use; two of three patients with CI, however, had their ischemic episode within 24 hours after the last of three LAK cell infusions. In conclusion, CI is an unusual complication of high‐dose IL‐2 and IFN immunotherapy. In patients receiving such combination therapy, severe diarrhea is a risk factor for the subsequent occurrence of CI.
AB - Colonic ischemia (CI) is a rare complication of high‐dose interleukin‐2 (IL‐2) immunotherapy. This complication occurred in three of 141 patients (2.1%) with metastatic cancer treated with high‐dose IL‐2 therapy; CI only developed in patients receiving interferon‐alpha (IFN) with IL‐2 (three of 21, 14%) compared with none of 120 in those patients receiving IL‐2 alone (P equals 0.0009). Severe diarrhea (≧ 7 bowel movements/day) also was significantly more common in patients receiving IFN with IL‐2 (six of 21, 29%) than in those receiving IL‐2 alone (three of 120, 2.5%, P equals 0.001) and preceded the clinical diagnosis of CI in all three patients. Three of nine patients with severe diarrhea had CI. Hematochezia occurred in four patients, all of whom received IFN with IL‐2; three had CI, and the other patient had nonspecific colitis. Differences in vasopressor use did not explain the increased risk of CI in patients receiving IFN; those receiving IFN with IL‐2 required phenylephrine less often than patients receiving IL‐2 alone (P equals 0.01). The administration of lymphokine‐activated killer (LAK) cells had no significant effect on the incidence of CI, severe diarrhea, peritonitis, or vasopressor use; two of three patients with CI, however, had their ischemic episode within 24 hours after the last of three LAK cell infusions. In conclusion, CI is an unusual complication of high‐dose IL‐2 and IFN immunotherapy. In patients receiving such combination therapy, severe diarrhea is a risk factor for the subsequent occurrence of CI.
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U2 - 10.1002/1097-0142(19911001)68:7<1538::AID-CNCR2820680714>3.0.CO;2-2
DO - 10.1002/1097-0142(19911001)68:7<1538::AID-CNCR2820680714>3.0.CO;2-2
M3 - Article
C2 - 1893354
AN - SCOPUS:0026333153
SN - 0008-543X
VL - 68
SP - 1538
EP - 1544
JO - Cancer
JF - Cancer
IS - 7
ER -