Kragel A H, Travis W D, Steis R G, Rosenberg S A, Roberts W C
Pathology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892.
Cancer. 1990 Oct 1;66(7):1513-6. doi: 10.1002/1097-0142(19901001)66:7<1513::aid-cncr2820660713>3.0.co;2-x.
The hearts of eight patients aged 22 to 67 years (mean, 41 years) who died during or within 4 days of interleukin-2 (IL-2) based immunotherapy for treatment of renal cell carcinoma or melanoma were studied at necropsy. Death resulted from combined cardiorespiratory failure in two patients, sepsis in four patients, acute myocardial infarction in one patient, and myocarditis in one patient. Transmural left ventricular necrosis was present in one of the two patients with significant atherosclerotic coronary artery narrowing. Noninfectious myocarditis was present in five patients: the inflammatory infiltrate was lymphocytic in four and composed of a mixture of eosinophils and lymphocytes in one. Although treatment-related deaths associated with high-dose IL-2 therapy are uncommon (1.5% in 652 consecutive patients), the potential for significant myocardial ischemia or myocarditis exists, and careful monitoring for arrhythmias or myocardial failure is warranted.
对8例年龄在22至67岁（平均41岁）的患者的心脏进行了尸检研究，这些患者在接受基于白细胞介素-2（IL-2）的免疫疗法治疗肾细胞癌或黑色素瘤期间或治疗后4天内死亡。两名患者死于心肺功能衰竭合并症，四名患者死于败血症，一名患者死于急性心肌梗死，一名患者死于心肌炎。在两名患有严重动脉粥样硬化性冠状动脉狭窄的患者中，有一名出现了透壁性左心室坏死。五名患者存在非感染性心肌炎：四名患者的炎性浸润为淋巴细胞性，一名患者的炎性浸润由嗜酸性粒细胞和淋巴细胞混合组成。尽管与高剂量IL-2治疗相关的治疗相关死亡并不常见（652例连续患者中为1.5%），但存在显著心肌缺血或心肌炎的可能性，因此有必要仔细监测心律失常或心肌衰竭。
