SAN ANTONIO--Physicians who treat HIV-infected patients may need
to brace for patient inquiries in light of evidence that low-dose
inter-leukin-2 (IL-2, Proleukin) may boost immune function following
remission-inducing chemotherapy for AIDS-related malignancies.
The IL-2 therapy led to increased production of eosinophils and
natural killer (NK) cells in AIDS patients with non-Hodgkin's
lymphoma or Kaposi's sarcoma, Dr. Michael Caligiuri said at a
lymphoma symposium sponsored by the University of Texas M.D. Anderson
No patient in the study developed opportunistic infections while
on 90-day courses of IL-2 therapy during 50 accumulated months,
and the treatment caused no grade 3 toxicities at the maximum
Also important in today's cost-containment environment, the research
showed that low-dose IL-2 can be safely self-injected in the home
setting, whereas patients must be hospitalized for administration
of moderate to high IL-2 doses, due to toxicities.
"We know that we can administer this therapy in the absence
of any significant toxicity. The question remains open as to whether
administration of such cytokines as IL-2 will help maintain remissions
or ultimately prevent development of lymphoma in immunocompro-mised
patients," said Dr. Caligiuri, associate professor of medicine,
Roswell Park Cancer Institute, Buffalo, NY.
Reflecting physicians' anticipation of patient reaction to the
news, Dudley Youman, an oncologist from Austin, Texas, asked,
"Are we going to have AIDS patients coming to us wanting
to be on IL-2 to prevent lymphoma, and, if so, what's the downside?"
"I would imagine there will be patients who inquire about
this," Dr. Caligiuri responded. "The downside is that
the jury is still out, so we should encourage patients as much
as we can to participate in the phase II and III clinical trials
that will answer the questions."