0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

The Hemodynamic Effects of Treatment with Interleukin-2 and Lymphokine-Activated Killer Cells

Ellen R. Gaynor, MD; Lauren Vitek, MD; Linda Sticklin, RN, MSN; Stephen P. Creekmore, MD; Mary E. Ferraro, BS; John X. Thomas Jr., PhD; Susan G. Fisher, MS; and Richard I. Fisher, MD
[+] Article and Author Information

Requests for Reprints: Ellen R. Gaynor, MD, Loyola University Stritch School of Medicine, 2160 South First Avenue, Maywood, IL 60153.

Current Author Addresses: Drs. Gaynor, Thomas, Fisher, and Ms. Ferraro: Loyola University Stritch School of Medicine, 2160 South First Avenue, Maywood, IL 60153.

Dr. Vitek, 1870 W. Dempster, Suite 410, Park Ridge, IL 60068

Dr. Creekmore, Biological Resources Branch, BRMP Frederick Cancer Research Facility, Frederick, MD 21701

Ms. Stricklin, 5200 Cleveland Street, Skokie, IL 60077

Ms. Fisher, Hines Veterans Administration Hospital, Hines, IL 60141


© 1988 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1988;109(12):953-958. doi:10.7326/0003-4819-109-12-953
Text Size: A A A

Study Objective: To determine the hemodynamic alterations occurring during therapy with the maximally tolerated doses of interleukin-2 and lymphokine-activated killer cells.

Design: Case series.

Setting: Referral-based inpatient oncology service at a university medical center.

Patients: A sequential sample of 13 patients with metastatic colon carcinoma, malignant melanoma, or hypernephroma who were receiving treatment with interleukin-2 and lymphokine-activated killer cells in the maximally tolerated doses.

Measurements and Main Results: Pretreatment variables of mean arterial pressure, systemic vascular resistance, heart rate, pulmonary capillary wedge pressure, and cardiac index were compared with the same variables measured either immediately before the eighth dose of interleukin-2 or immediately before the initiation of pressor support with dopamine hydrochloride. When these values were compared with the pretreatment values, patients showed a significant decrease in mean arterial pressure (92 mm Hg compared with 75 mm Hg; P < 0.0001), and systemic vascular resistance (15.1 compared with 8.5 mm Hg/L · min; P < 0.0001), but an increase in heart rate (73 compared with 110 beats/min; P < 0.0001) and cardiac index (3.1 compared with 4.7 L/min · m2 body surface area; P < 0.0001). No significant change was noted in pulmonary capillary wedge pressure. Low systemic vascular resistance persisted throughout interleukin-2 therapy. Although blood pressure normalized in 24 hours, the systemic vascular resistance remained below baseline levels 6 days after interleukin therapy had been stopped.

Interventions: Blood pressure was successfully supported at greater than 90 mm Hg with dopamine hydrochloride or phenylephrine hydrochloride, or both.

Conclusions: Therapy with high doses of interleukin-2 induces hemodynamic changes consistent with a high-output and low-resistance state similar to changes noted during the early phase of septic shock.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)