Chest roentgenographic abnormalities in IL-2 recipients. Incidence and correlation with clinical parameters

The chest roentgenograms of 54 patients receiving high dose interleukin-2 with or without lymphokine-activated killer cell therapy for advanced cancer were retrospectively reviewed. Thirty-nine patients (72 percent) developed chest roentgenographic abnormalities consisting of pleural effusions, 28 (...

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Veröffentlicht in:Chest 1992-03, Vol.101 (3), p.746-752
Hauptverfasser: VOGELZANG, P. J, BLOOM, S. M, MIER, J. W, ATKINS, M. B
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container_title Chest
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creator VOGELZANG, P. J
BLOOM, S. M
MIER, J. W
ATKINS, M. B
description The chest roentgenograms of 54 patients receiving high dose interleukin-2 with or without lymphokine-activated killer cell therapy for advanced cancer were retrospectively reviewed. Thirty-nine patients (72 percent) developed chest roentgenographic abnormalities consisting of pleural effusions, 28 (52 percent); diffuse infiltrates (pulmonary edema), 22 (41 percent); and focal infiltrates, 12 (22 percent). These abnormalities resolved in 30 of 39 (77 percent) patients by four weeks after therapy. Simple pleural effusions were the only residual roentgenographic abnormalities seen and were present primarily in patients receiving IL-2 by bolus intravenous injection (8 of 28) (29 percent) as compared to continuous intravenous infusion (1 of 24) (4 percent) (p = 0.03). Only roentgenographic evidence of pulmonary edema appeared to correlate with the degree of clinical pulmonary toxicity (p = 0.001). The development of chest roentgenographic abnormalities correlated with the administration of IL-2 solely by bolus intravenous injection (p = 0.04), a pretreatment FEV1 of less than 3 L (p = 0.04), and treatment associated bacteremia (p = 0.09), but not with prior therapy, the presence of pulmonary metastases or the degree of systemic capillary leak as measured by percentage of weight gain during therapy. Although the roentgenographic abnormalities did not relate to the number of LAK cells received, two patients developed sudden onset of dyspnea and chest roentgenographic evidence of pulmonary edema shortly after the first LAK cell administration, implying that a direct cause-and-effect relationship exists in some patients. Possible mechanisms for these IL-2 related chest roentgenographic abnormalities and pulmonary toxicity in general are discussed.
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Drug treatments</topic><topic>Pleural Effusion - diagnostic imaging</topic><topic>Pleural Effusion - etiology</topic><topic>Pulmonary Edema - diagnostic imaging</topic><topic>Pulmonary Edema - etiology</topic><topic>Radiography</topic><topic>Retrospective Studies</topic><topic>Toxicity: respiratory system, ent, stomatology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>VOGELZANG, P. J</creatorcontrib><creatorcontrib>BLOOM, S. M</creatorcontrib><creatorcontrib>MIER, J. W</creatorcontrib><creatorcontrib>ATKINS, M. B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>VOGELZANG, P. J</au><au>BLOOM, S. 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subjects Adult
Aged
Biological and medical sciences
Drug toxicity and drugs side effects treatment
Female
Humans
Immunotherapy, Adoptive
Interleukin-2 - adverse effects
Killer Cells, Lymphokine-Activated
Lung - diagnostic imaging
Lung Diseases - diagnostic imaging
Lung Diseases - etiology
Male
Medical sciences
Middle Aged
Neoplasms - therapy
Pharmacology. Drug treatments
Pleural Effusion - diagnostic imaging
Pleural Effusion - etiology
Pulmonary Edema - diagnostic imaging
Pulmonary Edema - etiology
Radiography
Retrospective Studies
Toxicity: respiratory system, ent, stomatology
title Chest roentgenographic abnormalities in IL-2 recipients. Incidence and correlation with clinical parameters
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