Gollob J A, Veenstra K G, Mier J W, Atkins M B
Department of Medicine, Harvard Medical School, Boston, Massachusetts 02215, USA.
J Immunother. 2001 Jan-Feb;24(1):91-8. doi: 10.1097/00002371-200101000-00011.
Interleukin-12 (IL-12) is a cytokine with effects on immune function and hematopoiesis. In this article, the authors describe two patients with renal cell cancer in whom grade 4 neutropenia and grade 3 hemolytic anemia developed, respectively, during treatment with twice-weekly intravenous recombinant human interleukin-12 (rhIL-12) during a phase 1 trial. The severe neutropenia was associated with bone marrow agranulocytosis and a preponderance of large granular lymphocytes in the peripheral blood, whereas the hemolytic anemia was negative for the Coombs test and associated with splenomegaly. The agranulocytosis and hemolytic anemia persisted after the rhIL-12 was stopped, but both subsequently responded to treatment with cyclophosphamide. steroids, or both. These findings indicate that rhIL-12 can induce unique hematologic toxic effects that can be reversed with immunosuppressive drugs.
白细胞介素-12（IL-12）是一种对免疫功能和造血功能有影响的细胞因子。在本文中，作者描述了两名肾细胞癌患者，在一项1期试验中，他们在接受每周两次静脉注射重组人白细胞介素-12（rhIL-12）治疗期间，分别出现了4级中性粒细胞减少和3级溶血性贫血。严重的中性粒细胞减少与骨髓粒细胞缺乏症以及外周血中大量颗粒淋巴细胞增多有关，而溶血性贫血的库姆斯试验呈阴性且与脾肿大有关。停用rhIL-12后，粒细胞缺乏症和溶血性贫血仍持续存在，但两者随后均对环磷酰胺、类固醇或两者联合治疗有反应。这些发现表明，rhIL-12可诱导独特的血液学毒性作用，而免疫抑制药物可逆转这些作用。
