Aldesleukin (IL-2, Proleukin) is a human recombinant interleukin-2 protein. Its antitumor action is thought to include multiple effects on the immune system, such as enhancement of T-lymphocyte cytotoxicity, induction of natural killer cell activity, and induction of interferon-7 production. Aldesleukin has been used alone and in combination with lymphokine activated killer (LAK) cells or tumor-infiltrating lymphocytes (TIL).
The drug produces remissions in 15% of patients with renal cell carcinoma, with median durations of remission of 18 to 24 months.
Several serious toxicities have been observed, with a fatality rate of 5% in the initial studies. The major adverse effect is severe hypotension in as many as 85% of patients, which may lead to myocardial infarctions, pulmonary edema, and strokes. This hypotension is thought to be due to a capillary leak syndrome resulting from extravasation of plasma proteins and fluid into ex-travascular space and a loss of vascular tone. Patients with significant cardiac, pulmonary, renal, hepatic, or CNS conditions should not receive therapy with aldesleukin. Other adverse reactions include nausea and vomiting, diarrhea, stomatitis, anorexia, altered mental status, fevers, and fatigue.
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