Continuous infusion of interleukin‐2 in children with refractory malignancies

Abstract

Background. The toxicity of interleukin‐2 (IL‐2) administered by continuous infusion has not been investigated in children. Methods. This study enrolled 10 boys and 7 girls with refractory malignancy. Recombinant IL‐2 was infused continuously for cycles of 120 hours at doses escalating from 3 to 30 × 106 IU/m2 per day. Results. A total of 45 cycles was administered. The most common toxicities included fever, anemia, hypotension (usually responsive to fluid bolus), hyponatremia, oliguria, hypoalbuminemia, nausea, thrombocytopenia, vomiting, and weight gain. Most side effects were correlated significantly with a dosage of 18 × 106 IU/m2 or more per day. Respiratory distress was infrequent. Two cycles were interrupted due to severe toxicity (hypotension in one case and confusion in another), but there were no fatalities. During infusion, there was a significant nondose‐related increase in serum IL‐2 receptor levels. Despite this evidence of immunomodulation, no objective tumor response was noted. Conclusions. Continuous infusion of IL‐2 at doses up to 30 × 106 IU/m2 per day can be administered safely to children by this method. Copyright © 1993 American Cancer Society