Chest
Interleukin-2 Administration Causes Reversible Hemodynamic Changes and Left Ventricular Dysfunction Similar to Those Seen in Septic Shock
Section snippets
Patients
Patients with tumors unresponsive to conventional therapy were admitted to the medical intensive care unit at the National Institutes of Health before the administration of interleukin-2, with or without the addition of lymphokine-activated killer (LAK) cells. All patients had consented to therapy with interleukin-2, and additional informed consent was obtained from each patient before any invasive hemodynamic monitoring.
Hemodynamic Monitoring
Heart rate (HR) was monitored using Hewlett-Packard ECG equipment.
Patients
In this study, five patients received high-dose (100,000 units/kg) interleukin-2, and four of these five patients also received LAK cells as antineoplastic immunotherapy for a duration of at least four days. Clinical data are summarized in Table 1. The underlying diseases were renal cell carcinoma (2), malignant melanoma (1), rhabdomyosarcoma (1), and widespread Kaposi's sarcoma due to the acquired immunodeficiency syndrome (1). None of these patients had received doxorubicin or other
DISCUSSION
Interleukin-2 administration was associated with a hemodynamic pattern that is similar to the hemodynamic changes seen in septic shock. These alterations, which occurred within 24 hours of interleukin-2 administration, included profound tachycardia, decreased mean arterial blood pressure, increased cardiac index, decreased systemic vascular resistance, and decreased left ventricular stroke work index. All of these hemodynamic changes have been well described in human septic shock.12, 13, 14, 15
ACKNOWLEDGMENTS
The authors thank the nursing and technical staffs of the Medical Intensive Care Unit, NIH, for their assistance in patient care and data collection during the administration of interleukin-2; the nurses from the Department of Nuclear Medicine for performing the radionuclide studies; and Kathy Kiefer and Shelia Robinson for preparation of the manuscript.
Reference (21)
- et al.
Multiple gated blood pool imaging for left ventricular ejection fraction: validation of the technique and assessment of variability
Am J Cardiol
(1979) - et al.
Hemodynamic studies and results of therapy in 50 patients with bacteremic shock
Am J Med
(1973) - et al.
In vivo interleukin-2 administration augments the generation of alloreactive cytolytic T lymphocytes and resident natural killer cells
J Immunol
(1983) - et al.
In vivo administration of interleukin-2 enhances specific alloimmune responses
Transplantation
(1983) - et al.
In vitro growth of cytotoxic human lymphocytes: IV Lysis of fresh and autologus tumor of lymphocytes cultured in T-cell growth factor
Cancer Res
(1981) - et al.
In vitro growth of murine T cells: V The isolation and growth of lymphoid cells infiltrating syngeneic solid tumors
J Immunol
(1980) - et al.
Biological activity of recombinant human interleukin-2 produced in Escherichia coli.
Science
(1984) Adoptive immunotherapy of cancer using lymphokine activated killer cells and recombinant interleukin-2
- et al.
Observations on the systemic administration of autologous lymphokine-activated killer cells and recombinant interleukin-2 to patients with metastatic cancer
N Engl J Med
(1985) - et al.
High dose recombinant interleukin-2 in the treatment of patients with disseminated cancer: responses, treatment related morbidity and histologic findings
JAMA
(1986)
Cited by (169)
Cardiovascular Problems in Acute Kidney Injury
2019, Critical Care Nephrology: Third EditionCardiac Effects of Cancer Therapy
2013, Abeloff's Clinical Oncology: Fifth EditionPhysiology of the Newborn
2010, Ashcraft's Pediatric SurgeryQuantitative analysis of cytokine-induced vascular toxicity and vascular leak in the mouse brain
2009, Journal of Immunological MethodsPHYSIOLOGY OF THE NEWBORN
2009, Ashcraft's Pediatric Surgery, Fifth Edition
Presented in part at the annual meeting, American Federation for Clinical Research, May 1986, and at the Annual Symposium of Critical Care Medicine, May 1986. Published in abstract form in Clinical Research 1986; 34:413A, and in Critical Care Medicine 1986; 14:352.
Manuscript received January 5; revision accepted March 22.