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Related to IL-2: IL-2 receptor

aldesleukin (interleukin-2, IL-2)


Pharmacologic class: Interleukin-2 (IL-2), human recombinant (cytokine)

Therapeutic class: Antineoplastic (miscellaneous)

Pregnancy risk category C

FDA Box Warning

• Give only to patients with normal cardiac and pulmonary function, as shown by thallium stress testing and pulmonary function testing. Use extreme caution when giving to patients with normal thallium stress test and normal pulmonary function tests who have a history of cardiac or pulmonary disease.

• Give under supervision of physician experienced in cancer chemotherapy, in setting where intensive care facilities and cardiopulmonary or intensive care specialists are available.

• Drug is linked to capillary leak syndrome, which causes hypotension and reduced organ perfusion (possibly severe and resulting in death).

• Before starting drug, preexisting bacterial infections must be treated, because drug may impair neutrophil function and increase disseminated infection risk. Patients with indwelling central lines are at special risk for infection with gram-positive microorganisms. Prophylactic antibiotics can help prevent staphylococcal infections.

• Withhold drug in patients who develop moderate to severe lethargy or somnolence; continued administration may cause coma.


Activates cellular immunity and inhibits tumor growth by increasing lymphocytes and cytokines, which lyse tumor cells


Injection: 22 million international units/vial

Indications and dosages

Metastatic renal cell carcinoma and metastatic melanoma

Adults older than age 18: 600,000 international units/kg I.V. given over 15 minutes q 8 hours for a maximum of 14 doses, followed by 9 days of rest. Repeat for another 14 doses, for a maximum of 28 doses per course.

Off-label uses

• Colorectal cancer

• Kaposi's sarcoma

• Non-Hodgkin's lymphoma


• Hypersensitivity to drug

• Arrhythmias, cardiac tamponade, seizures, severe GI bleeding, coma or toxic psychosis lasting more than 48 hours

• Organ allograft

• Abnormal thallium stress test or pulmonary function test results


Use cautiously in:

• anemia, bacterial infections, heart disease, CNS metastases, hepatic disease, pulmonary disease, renal disease, thrombocytopenia

• pregnant or breastfeeding patients

• children.


• Make sure patient's thallium stress test and pulmonary function test results are normal before giving.

Don't give if patient is drowsy or severely lethargic; contact prescriber immediately.

• Reconstitute drug according to label directions with 1.2 ml of sterile water for injection by injecting diluent against side of vial (to prevent excessive foaming).

• Further dilute reconstituted dose with 50 ml of 5% dextrose injection.

• Administer I.V. infusion over 15 minutes.

• Don't use in-line filter.

Adverse reactions

CNS: dizziness, mental status changes, syncope, sensory or motor dysfunction, headache, fatigue, rigors, weakness, malaise, poor memory, depression, sleep disturbances, hallucinations

CV: bradycardia, sinus tachycardia, premature atrial complexes, premature ventricular contractions, arrhythmias, myocardial ischemia, cardiac arrest, capillary leak syndrome and severe hypotension, myocardial infarction EENT: reversible vision changes, conjunctivitis

GI: nausea, vomiting, diarrhea, constipation, dyspepsia, abdominal pain, stomatitis, anorexia, intestinal perforation, ileus, GI bleeding

GU: hematuria, proteinuria, dysuria, renal failure, oliguria or anuria Hematologic: anemia, purpura, eosinophilia, thrombocytopenia, coagulation disorders, leukopenia, leukocytosis

Hepatic: jaundice, ascites

Metabolic: hyperglycemia, hypoglycemia, acidosis, alkalosis

Musculoskeletal: joint and back pain, myalgia

Respiratory: cough, chest pain, tachypnea, wheezing, dyspnea, pulmonary congestion, pulmonary edema, respiratory failure, apnea, pleural effusion

Skin: erythema, pruritus, rash, dry skin, petechiae, urticaria, exfoliative dermatitis

Other: weight gain or loss, fever, chills, edema, infection, pain or reaction at injection site, hypersensitivity reaction


Drug-drug. Aminoglycosides, asparaginase, cytotoxic chemotherapy agents, doxorubicin, indomethacin, methotrexate: increased toxicity

Antihypertensives: increased hypotensive effect

Glucocorticoids: reduced antitumor effects

Drug-diagnostic tests. Alkaline phosphatase, bilirubin, glucose, blood urea nitrogen, creatinine, potassium, transaminases: increased levels

Calcium, glucose, magnesium, phosphorus, potassium, protein sodium, uric acid: decreased levels

Patient monitoring

• Monitor heart rate and rhythm, vital signs, and fluid intake and output.

• Assess for signs and symptoms of hypersensitivity reaction and infection.

• Monitor for adverse CNS effects. Report these immediately.

• Evaluate chest X-rays.

• Monitor CBC, electrolyte levels, and liver and kidney function test results.

Patient teaching

Tell patient that drug lowers resistance to infections. Advise him to immediately report fever, cough, breathing problems, and other signs or symptoms of infection.

Advise patient to immediately report chest pain, irregular or fast heart beats, easy bruising or bleeding, or abdominal pain.

• Instruct patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.

• Provide dietary counseling. Refer patient to dietitian if adverse GI effects significantly limit food intake.

• Notify patient that he'll undergo blood testing and have chest X-rays taken during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


A gene on chromosome 4q26-q27 that encodes interleukin-2, a cytokine secreted by T cells in response to antigenic or mitogenic stimulation that plays a central role in the proliferation of T and B lymphocytes. IL-2 upregulates B-cells, monocytes, lymphokine-activated killer cells, natural killer cells and glioma cells.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Aldesleukin, IL-2, T-cell growth factor Immunology An immunomodulating biological response modifier produced at low baseline levels by CD4 T cells; after antigen presentation by antigen-presenting cells in presence of
IL-1, T cell production of IL-2 and IL-2 receptor–IL-2Rβ on membrane ↑, peaks at 6 hrs and falls to baseline levels; IL-2 is also produced by medullary thymocytes and a subset of large granular lymphocytes–NK cell activators; IL-2 up-regulates the immune system, causing lymphokine-activated killer–LAK cells to lyse tumor cells, see IL-2/LAK cells Therapeutics Recombinant IL-2 has been used for various conditions, including metastatic renal cell CA Adverse effects IL-2 therapy requires wks of intensive care due to toxic effects, including a 'capillary leakage syndrome. ', malaise, gastritis, GI symptoms, anemia, thrombocytopenia, rigors, chills, fever, hypotension, azotemia, jaundice, hyperbilirubinemia, rash–erythroderma globalis, confusion, ascites, fluid retention, pruritus, agitation, respiratory insufficiency, cardiac failure, irreversible demyelinization and hypothyroidism. See IL-2/LAK cells.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
o IL-1?, IL-1?, IL-2, IL-3, IL-4, IL-6, IL-10, IL-12p70, IL-17, MCP-1, TNF-?, MIP-1?, GMCSF, RANTES
No association was observed between serum anti-IL-2 IgG and the other parameters, which included age, disease duration, white blood cells, hemoglobin, platelets, complements, anti-dsDNA antibodies, AnuA, 24 h proteinuria excretion, and serum IL-2 (data not shown).
IL-15 activates a number of intracellular signaling molecules, including the janus kinase and members of the transcription factor family of signal transducers and activators of transcription.8 Due to sharing of receptor subunits between IL-2 and IL-15, both of these cytokines have similar downstream effects in T cells, including the induction of bci-2, the activation of the MAP Kinase pathway, and the phosphorylation of ick and syk kinases.10
Values Small Van Krevelen Hoy -[CH.sub.3] 438 420 303.4 -COO- 634 512 668 [FORMULA NOT REPRODUCIBLE IN ASCII] 57 140 176 The solubility parameter of IL-2 was calculated using a molar volume of 651 [cm.sup.3]/mol by the same group contribution technique.
In both trials, people taking IL-2 with antiretrovirals rapidly gained more CD4 cells than people taking only antiretrovirals, although the antiretroviral-only groups steadily gained CD4 cells throughout the study.
In general, increased numbers of IL-2, IL-10 or IL-2R positive cells were found in tissues from patients with CIN when compared to adjacent normal tissues and normal controls.
Possible reasons for the positive findings observed by Dybul and colleagues, (24) include different HAART study regimens, shorter treatment interruption, absence of drug-resistance mutations prior to study enrollment, higher CD4 T cell nadir, and history of IL-2 treatment in the majority of patients (patients in other comparable studies had no history of IL-2).
The levels of IFN-[gamma], IL-2, and IL-6 in the culture supernatants were determined using the commercially developed enzyme-linked immunosorbent assays (ELISA) (BioSource International, Inc., Camarillo, CA) and a spectrophotometric microplate reader (SpectraMax 250; Molecular Devices Co., Sunnyvale, CA).
Compared with either drug alone, IL-2 and M40403 together were better at reducing the spread of cancer in mice.
In addition, the FDA reiterated the need to demonstrate a significant benefit of Ceplene/IL-2 vs IL-2 monotherapy on overall survival, which needs to be the primary endpoint of the trial.
By the early 1990s, it was clear that IL-2, when used intermittently and in conjunction with anti-HIV therapy, had the most pronounced impact on increasing CD4 T cell counts of any therapy ever studied for the treatment of HIV disease.