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Post-transplant interleukin-2 in patients with low-grade lymphoid neoplasms previously treated with fludarabine is limited by hematologic toxicity

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Abstract

Given the favorable immunologic effects of IL-2 post transplant, we conducted a feasibility study examining rIL-2 1.0×106 IU/m2/day (SQ) beginning on D+14 post-transplant and continuing for 90 days in 12 patients with low-grade lymphoproliferative disorders. Prior to high-dose chemotherapy and autologous peripheral blood stem cell transplantation (HDCT), 11 patients underwent cytoreduction with fludarabine and cyclophosphamide (Flu/Cy); 11 were in complete remission (CR) and one was in partial remission at the time of HDCT. All 12 patients were in CR 90 days post-HDCT. At a median follow-up of 30 (range 3–44) months, seven patients (58%) remain in remission, four are alive with disease, and one has died of disease progression, resulting in an overall survival of 92%. Kaplan-Meier estimates of progression-free survival (PFS) for the group demonstrate a median of 31 (range 3–43) months. Five patients required rIL-2 cessation at 8–58 days after starting the therapy due to hematologic toxicity. These results are comparable to those achieved in other published bone marrow and peripheral blood stem cell transplantion (PBSCT) series without the addition of rIL-2. Furthermore, rIL-2 using this schedule following fludarabine-based cytoreduction was associated with excessive hematologic toxicity.

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Acknowledgements

We would like to thank the patients and our transplant nurses for their assistance in making this work possible. We are deeply indebted and we greatly appreciate the important contributions made by Dr. John C. Byrd.

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Authors and Affiliations

  1. Hematology/Oncology Service, Ward 78, Walter Reed Army Medical Center, 6900 Georgia Ave., Washington, DC 20307, USA

    Jamie K. Waselenko, Ann Burrows, Margaret Lucas, William Jeffrey Edenfield & Rick C. Myhand

  2. Hematology/Oncology Service, Brooke Army Medical Center, Fort Sam Houston, Texas, USA

    Douglas A. Nelson & John Ekstrand

Authors
  1. Jamie K. Waselenko
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  2. Ann Burrows
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  3. Douglas A. Nelson
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  4. Margaret Lucas
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  7. Rick C. Myhand
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Correspondence to Jamie K. Waselenko.

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The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the U.S. Army or the Department of Defense

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Waselenko, J.K., Burrows, A., Nelson, D.A. et al. Post-transplant interleukin-2 in patients with low-grade lymphoid neoplasms previously treated with fludarabine is limited by hematologic toxicity. Ann Hematol 82, 552–557 (2003). https://doi.org/10.1007/s00277-003-0726-x

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  • DOI: https://doi.org/10.1007/s00277-003-0726-x

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