Denicoff K D, Rubinow D R, Papa M Z, Simpson C, Seipp C A, Lotze M T, Chang A E, Rosenstein D, Rosenberg S A
Ann Intern Med. 1987 Sep;107(3):293-300. doi: 10.7326/0003-4819-107-2-293.
To study the neuropsychiatric manifestations of therapy with interleukin-2 and lymphokine-activated killer cells.
Longitudinal survey of consecutive patients who were given the treatment. Each patient was initially interviewed within 5 days before treatment, and a personal and family psychiatric history was obtained during this first session. Cognitive tests and mood self-rating instruments were administered at the beginning and end of interleukin-2 and lymphokine-activated killer cell treatments, before discharge, and at a follow-up visit 2 to 4 weeks after discharge.
National Cancer Institute inpatient units at the National Institutes of Health.
Sequential samples of 44 patients with metastatic cancer (age range, 28 to 69 years) who were treated systemically with recombinant interleukin-2 combined with autologous lymphokine-activated killer cells between 30 December 1985 and 31 March 1986.
Of the 44 patients studied, 15 developed severe behavioral changes that necessitated acute intervention, and 22 patients had severe cognitive changes (all 22 became disoriented and many also had psychometric evidence of cognitive deterioration). The neuropsychiatric side effects were dose and time related, appearing more frequently at the higher dose and almost uniformly at the end of each treatment phase. All 39 patients who were seen at follow-up had a return to their baseline cognitive scores. None of the factors investigated was found to be predictive of the development of neuropsychiatric toxicity.
The development of clinically significant neuropsychiatric changes during the administration of interleukin-2 and lymphokine-activated killer cells was common and may be treatment limiting. A marked latency in the appearance of neuropsychiatric changes after treatment onset was noted in almost all patients. Every patient studied recovered from the neuropsychiatric side effects.
研究白细胞介素-2和淋巴因子激活的杀伤细胞治疗的神经精神表现。
对接受该治疗的连续患者进行纵向调查。每位患者在治疗前5天内首次接受访谈，并在首次访谈时获取个人和家族精神病史。在白细胞介素-2和淋巴因子激活的杀伤细胞治疗开始和结束时、出院前以及出院后2至4周的随访中进行认知测试和情绪自评工具评估。
国立卫生研究院的国立癌症研究所住院部。
1985年12月30日至1986年3月31日期间，44例转移性癌症患者（年龄范围28至69岁）接受重组白细胞介素-2联合自体淋巴因子激活的杀伤细胞全身治疗的连续样本。
在研究的44例患者中，15例出现严重行为改变，需要进行急性干预，22例出现严重认知改变（所有22例均出现定向障碍，许多患者还有认知功能恶化的心理测量证据）。神经精神副作用与剂量和时间相关，在较高剂量时更频繁出现，且几乎在每个治疗阶段结束时均出现。在随访中见到的所有39例患者的认知得分均恢复至基线水平。未发现所研究的任何因素可预测神经精神毒性的发生。
在白细胞介素-2和淋巴因子激活的杀伤细胞治疗期间，出现具有临床意义的神经精神改变很常见，且可能限制治疗。几乎所有患者在治疗开始后神经精神改变出现的潜伏期都很长。每个研究患者的神经精神副作用均已恢复。
