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 Cancer Center.
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 tolerated dose.
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."