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Colonic ischemia complicating immunotherapy with interleukin-2 and interferon-alpha
J A Sparano1, J P Dutcher, R Kaleya
1Department of Oncology, Albert Einstein Cancer Center, Montefiore Medical Center, Bronx, NY 10467.
Cancer
|October 1, 1991
Summary
Colonic ischemia (CI) is a rare complication of high-dose interleukin-2 (IL-2) immunotherapy. Severe diarrhea, a common side effect of IL-2 with interferon-alpha (IFN), is a significant risk factor for developing CI.
Area of Science:
- Oncology
- Immunotherapy
- Gastroenterology
Background:
- High-dose interleukin-2 (IL-2) is used for metastatic cancer treatment.
- Colonic ischemia (CI) is a rare but serious complication of IL-2 therapy.
- The role of concurrent interferon-alpha (IFN) in CI development is unclear.
Observation:
- CI occurred in 2.1% of patients receiving high-dose IL-2.
- CI incidence rose to 14% in patients receiving IL-2 with IFN.
- Severe diarrhea (≥7 bowel movements/day) was more frequent with IL-2 + IFN (29%) vs. IL-2 alone (2.5%).
Findings:
- CI was significantly associated with the combination of IL-2 and IFN (P=0.0009).
- Severe diarrhea preceded CI diagnosis in all affected patients.
- Three out of nine patients with severe diarrhea developed CI.
- Hematochezia occurred in four patients, all on IL-2 + IFN; three had CI.
Implications:
- Severe diarrhea is a key risk factor for CI in patients receiving IL-2 and IFN combination therapy.
- Close monitoring for GI symptoms is crucial in patients undergoing this immunotherapy.
- Understanding these risks can guide clinical management and improve patient outcomes.