Tourani J M, Levy V, Briere J, Levy R, Franks C, Andrieu J M
Department of Oncology/Hematology, Laennec Hospital, Paris, France.
Eur J Cancer. 1991;27(12):1676-80. doi: 10.1016/0277-5379(91)90444-i.
Recombinant interleukin-2 (rIL-2) has been reported to be active in metastatic renal cell carcinoma and malignant melanoma. The purpose of this trial was to determine the efficacy and toxicity of rIL-2 administered in continuous infusion in patients with Hodgkin's disease (HD) and non-Hodgkin lymphoma (NHL). 21 patients with HD (4 patients), diffuse large-cell NHL (7) or low-grade NHL (10) in failure or relapse after multiple-conventional treatments were included in this trial. rIL-2 therapy consisted of an induction period of two cycles separated by 3 weeks of rest, and, in the absence of progressive disease or undue toxicity, a maintenance period of 4 monthly cycles. Each induction cycle comprised the continuous infusion of rIL-2: 18 x 10(6) IU/m2 per day on days 1-5 and days 12-16. Each maintenance cycle comprised the continuous infusion of rIL-2: 18 x 10(6) IU/m2 per day on days 1-5. Among the 21 treated patients, 5 (all of those with low-grade NHL) responded to the induction phase (1 complete response, 4 partial responses) and 2 patients had a mixed response. Conversely, no response was observed in patients with HD or large-cell NHL. The median duration of response was 4 months. rIL-2 administered as a continuous infusion was well tolerated and most patients received the full dosage, and management did not require intensive care. During the induction period, 2 patients experienced grade III cardiovascular or renal toxicity. During the maintenance period, rIL-2 had to be interrupted in 1 patient because of a myocardial infarction. This trial confirms the inefficacy of rIL-2 for the treatment of large-cell NHL and HD. Conversely, in low-grade NHL, rIL-2 activity needs to be explored by further studies. rIL-2 may have a place in the early phase of the disease, when the immune system is not compromised, as an adjuvant treatment in residual disease in order to improve the duration of response.
重组白细胞介素-2（rIL-2）已被报道在转移性肾细胞癌和恶性黑色素瘤中具有活性。本试验的目的是确定持续输注rIL-2对霍奇金病（HD）和非霍奇金淋巴瘤（NHL）患者的疗效和毒性。本试验纳入了21例经过多次传统治疗后失败或复发的HD患者（4例）、弥漫性大细胞NHL患者（7例）或低度NHL患者（10例）。rIL-2治疗包括两个诱导周期，中间休息3周，并且在无疾病进展或过度毒性的情况下，进行4个每月周期的维持治疗。每个诱导周期包括rIL-2的持续输注：在第1 - 5天和第12 - 16天，每天18×10⁶IU/m²。每个维持周期包括rIL-2的持续输注：在第1 - 5天，每天18×10⁶IU/m²。在21例接受治疗的患者中，5例（均为低度NHL患者）对诱导期有反应（1例完全缓解，4例部分缓解），2例患者有混合反应。相反，HD或大细胞NHL患者未观察到反应。反应的中位持续时间为4个月。持续输注的rIL-2耐受性良好，大多数患者接受了全剂量，且治疗管理不需要重症监护。在诱导期，2例患者出现III级心血管或肾脏毒性。在维持期，1例患者因心肌梗死不得不中断rIL-2治疗。本试验证实rIL-2对大细胞NHL和HD治疗无效。相反，在低度NHL中，rIL-2的活性需要通过进一步研究来探索。rIL-2在疾病早期免疫系统未受损时，作为残留疾病的辅助治疗以延长反应持续时间方面可能有一席之地。
