Physical symptoms of combination biotherapy: a quality-of-life issue

Data are available on the principal side effects of individually administered biological response modifiers (BRMs). However, studies on physical symptoms secondary to multiagent regimens (i.e., combinations of BRMs and of BRMs and chemotherapy) are just now appearing in the literature. The combinations of alpha interferon and 5-FU and of alpha interferon and interleukin-2 (IL-2) are the focus of this paper. Published and unpublished reports of side effects associated with these combinations are reviewed, and resulting quality-of-life (QOL) issues examined. Physical side effects that may affect QOL are flu-like symptoms, gastrointestinal (GI) toxicities, and fatigue, which may alter social, physiological, and psychological function and negatively influence the perception of QOL. Nursing interventions to improve these reactions include awareness and assessment of the patient's perception of QOL and strategies to alleviate the symptoms. Numerous opportunities exist for nursing research on improved symptom management and on QOL in combination biotherapy regimens.