Low-dose rIL-2-induced remission of disseminated CD30+ anaplastic large-cell lymphoma through reinforcement of presumed T-cell-mediated tumor cell killing, complicated by unilateral drowning of lymphoma-infiltrated lung.

We report on the immuno-oncologic analysis and treatment of a remarkable case of disseminated CD30+ anaplastic non-Hodgkin's lymphoma. Its clinical course was characterized by repeated spontaneous regressions, which were probably due to a T-cell-mediated anti-lymphoma immune reaction, as tumor-infiltrating T lymphocytes were consistently observed in sections of lymphoma lesions and found to express high-affinity receptors for interleukin-2 (IL-2). This marker may be particularly suitable to predict a response to low-dose recombinant IL-2 (rIL-2), as confirmed in this case by prompt lymphoma regression after regional rIL-2 perfusion of a cutaneous lesion and by an impressive overall response to systemic rIL-2 treatment. Despite the very low dose of rIL-2, 600,000 IU/24 h as a continuous i.v. infusion, systemic treatment was complicated by generalized capillary leakage and life-threatening unilateral drowning of the lymphoma-infiltrated left lung.