持续输注重组白细胞介素-2对血流动力学的影响

Jeffrey S. Groeger , Dean Bajorin , Bonnie Reichman , Isabelle Kopec , Omar Atiq , Mary Kathryn Pierri
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引用次数: 2

摘要

重组白细胞介素-2 (rhIL-2)过继免疫治疗已被报道可诱导一些难治性癌症患者的肿瘤消退。然而,大剂量治疗的心血管毒性需要在重症监护病房(ICU)对患者进行侵入性监测。为了研究持续输注IL-2引起的血流动力学改变,而不是大剂量治疗,我们研究了10例无心脏病证据的患者的血流动力学变量,这些患者每天接受3 × 106 IU/m2的IL-2连续输注5天。在注射前、注射后2、24、48小时和结束后立即获得测量和导出的血流动力学变量。这些患者没有临床血流动力学不稳定的证据。除发热和心动过速外,在任何测量或推导的血流动力学参数方面均无临床显著差异。此外,这些患者在输注期间的连续心电图监测未发现任何异常。在ICU中,对于精心挑选的以所述剂量和方案持续输注rhIL-2的患者,无需进行侵入性血流动力学监测。
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Haemodynamic effects of recombinant interleukin-2 administered by constant infusion

Adoptive immunotherapy with recombinant interleukin-2 (rhIL-2) has been reported to induce tumour regression in some patients with refractory cancer. However, the cardiovascular toxicity of bolus therapy requires invasive monitoring of patients in the intensive care unit (ICU). In an effort to examine the haemodynamic alterations caused by a constant infusion of IL-2, as opposed to bolus therapy, we studied the haemodynamic variables of 10 patients, with no evidence of heart disease, receiving 3 × 106 IU/m2 per day of rhIL-2 as a continuous infusion for 5 days. Measured and derived haemodynamic variables were obtained immediately prior to, at 2, 24, and 48 h during, and upon termination of the infusion. There was no evidence of clinical haemodynamic instability in these patients. Except for development of fever and tachycardia, there were no clinically significant differences in any measured or derived haemodynamic parameter. Moreover, continuous electrocardiographic monitoring of these patients during the infusion did not reveal any abnormalities. Invasive haemodynamic monitoring in an ICU is not necessary in carefully selected patients receiving constant infusion rhIL-2, at the described dose and schedule.

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