Colonic ischemia complicating immunotherapy with interleukin-2 and interferon-alpha

Article Abstract:

In recent years, interest has grown in the potential for using biologic response modifiers in the treatment of cancer. Biologic response modifiers are a group of various substances used by the body to control changes in cells and tissues, often those of the immune system. Interleukin-2 (IL-2) has been widely studied due to its ability in the laboratory to promote the killing of tumors by cells of the immune system. However, the use of IL-2 in larger doses causes several serious side effects including gastrointestinal toxicity, which results in nausea, vomiting, diarrhea, and abnormal liver function. However, interleukin-2 treatment by itself has never been observed to cause colonic ischemia. In colonic ischemia, the blood flow to portions of the colon is restricted, damaging the tissue. The condition is accompanied by cramp-like pain and bright red blood in the feces within a day. Evidence is now accumulating to suggest that colonic ischemia may occur as a complication when cancer patients are treated with both IL-2 and interferon-alpha, even though neither of these drugs produces the condition alone. Of 141 patients being treated with high-dose interleukin-2, only 21 received interferon-alpha in addition. Colonic ischemia developed in three of these 21 patients, and in none of the 120 patients who received high-dose IL-2 without the interferon. Severe diarrhea, as well, occurred more often among the 21 patients treated with both substances than in those treated only with IL-2. Three case reports are included. As biologic response modifiers become more commonly used therapeutically, physicians must become more alert to the side effects they may cause. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Drug therapy, Combination, Combination drug therapy, Interferon alpha, Interleukin-2, Intestinal ischemia

---

Increasing recognition of corticosteroid-induced tumor lysis syndrome in non-Hodgkin's lymphoma

Article Abstract:

Somewhat ironically, the rapid death of cancer cells in a patient undergoing chemotherapy may be a life-threatening condition, and even a cause of sudden death. The condition, called acute tumor lysis syndrome, begins when many cancer cells disintegrate and release their contents into the patient's body. The result is a rapid increase in potassium, calcium, uric acid, phosphate, and lactic acid in the blood. Kidney failure may result. Acute tumor lysis is most common among patients with high-grade lymphomas such as Burkitt's lymphoma or lymphoblastic lymphoma, and with acute lymphocytic leukemia. While the condition is most likely to result from treatment with cytotoxic drugs, a case was recently seen in which the tumor lysis resulted from treatment with corticosteroids. A 19-year-old man with a high-grade non-Hodgkin's lymphoma was treated for apparent spinal cord compression with an emergency injection of dexamethasone. Within 12 hours, changes in the blood chemistry indicative of acute tumor lysis appeared. The patient was appropriately treated; within two days the abdominal lymphoma was no longer palpable. Two other cases have appeared in the medical literature describing acute tumor lysis resulting from corticosteroid treatment. One of the three cases now reported indicates that acute tumor lysis may result even from moderate corticosteroid doses. However, all three cases were high-grade lymphomas, which suggests that the patients susceptible to acute tumor lysis syndrome from corticosteroids are probably similar to those susceptible from cytotoxic drug treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Adrenocortical hormones, Non-Hodgkin's lymphomas, Steroid hormones

---

Acute tumor lysis syndrome and treatment response in patients treated for refractory chronic lymphocytic leukemia with short-course, high-dose cytosine arabinoside, cisplatin, and etoposide

Article Abstract:

Acute tumor lysis syndrome results from the rapid breakdown of neoplastic cells, such as occurs in tumors after anticancer treatment. This syndrome rarely occurs, and may be associated with rapidly growing lymphatic tumors or tumors of the lymphoid system. Four patients with advanced chronic lymphocytic leukemia (CLL), a blood cancer, developed acute tumor lysis syndrome after treatment with a drug regimen of cytosine arabinoside, cisplatin, and etoposide (ACE). Acute tumor lysis was prevented in three subsequent patients with CLL who were treated with ACE by: increasing water intake; decreasing the hydrogen levels in the urine; forcing excretion of body fluids; and administering allopurinol, a drug that decreases blood and urine levels of uric acid. The numbers of lymphocytes, a type of immune cell, were decreased by the first course of therapy in seven of eight patients treated with ACE. Three of the eight patients survived, including one in complete remission, one in partial remission, and one with CLL transformed to large cell lymphoma, a tumor of the lymphoid system. One patient died of complications associated with acute tumor lysis and pancytopenia, a reduction in blood cells; four additional patients died of complications associated with severe pancytopenia and general debilitation or impairment. These findings show that ACE causes the rapid breakdown of tumor cells in CLL. Management of tumor lysis and infectious complications may improve the survival of patients with advanced CLL. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Lymphocytic leukemia, Cisplatin, Cytarabine, Etoposide

Similar abstracts:

• Abstracts: The Jarisch-Herxheimer reaction complicating syphilotherapy in pregnancy. Sexual assault in pregnancy
• Abstracts: Intestinal infarction after intravenous cocaine administration. Potentiation of cocaine-induced coronary vasoconstriction by beta-adrenergic blockade
• Abstracts: Special considerations for managing suspected human immunodeficiency virus infection and AIDS in patients from developing countries
• Abstracts: Pneumococcal septic arthritis of the knee in a patient with multiple myeloma. Haemophilus parainfluenzae bacteremia associated with a pacemaker wire localized by gallium scan
• Abstracts: Treatment of polymyalgia rheumatica with intramuscular injections of depot methylprednisolone

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.