Document Detail


Interleukin-4 in the treatment of AIDS-related Kaposi's sarcoma.
MedLine Citation:
PMID:  9093711     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To define the safety and toxicity of interleukin-4 (IL-4) when administered subcutaneously in patients with AIDS-related Kaposi's sarcoma (AIDS-KS); to evaluate the effect of IL-4 on immunologic and virologic parameters; and to preliminarily assess the response rate of IL-4 in AIDS-KS. PATIENTS AND METHODS: Eighteen patients with mucocutaneous, non-visceral AIDS-KS were treated with IL-4 at a dose of 1 mcg/kg subcutaneously, daily until unacceptable toxicity or for a maximum period of six months. Twelve (66%) patients had extensive mucocutaneous disease with over 25 lesions. Ten patients had received prior systemic chemotherapy. Seventeen had CD4+ lymphocyte counts less than 200/mm3. RESULTS: The most common adverse effects included headache in 78%, fever in 56%, chills in 44%, and edema in 44%. Hematologic toxicities consisted of grade 4 neutropenia (less than 500/mm3) in 33%, mild anemia in 22%. Transient elevation of liver enzymes was noted in 17%. A transient elevation in CD4+ lymphocyte counts occurred during the first two weeks of therapy. Four of eleven patients tested showed marked decline in plasma HIV RNA after four weeks. Partial remission was observed in one patient, lasting six months. Three other patients (17%) had stable disease: 7 weeks in one patient, and 10 weeks in each of the two other patients. CONCLUSION: Grade 4 neutropenia (absolute neutrophil count < 500/mm3) was the most common hematologic adverse effect with IL-4 in patients with AIDS-KS. In contrast to in vitro findings, there was a decrease in plasma HIV RNA after four weeks of IL-4 therapy in the majority of patients tested. IL-4 produced minimal anti-tumor effects in AIDS-KS with one partial remission in a patient with CD4 lymphocyte counts over 200/mm3. Further studies of IL-4 in AIDS-KS may be considered in patients with better immune status.
Authors:
A Tulpule; B Joshi; N DeGuzman; B M Espina; R Mocharnuk; O Prakash; D Templeton; A M Levine; P S Gill
Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of oncology : official journal of the European Society for Medical Oncology / ESMO     Volume:  8     ISSN:  0923-7534     ISO Abbreviation:  Ann. Oncol.     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-09-26     Completed Date:  1997-09-26     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  9007735     Medline TA:  Ann Oncol     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  79-83     Citation Subset:  IM; X    
Affiliation:
Department of Internal Medicine, University of Southern California School of Medicine, Los Angeles, USA.
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / complications*
Adult
CD4 Lymphocyte Count / drug effects
CD8-Positive T-Lymphocytes
Capillary Leak Syndrome / chemically induced
Disease Progression
Drug-Induced Liver Injury / therapy
Fever / chemically induced
Gastrointestinal Diseases / chemically induced
HIV Core Protein p24 / blood
HIV-1 / isolation & purification
Headache / chemically induced
Hematologic Diseases / chemically induced
Humans
Immunologic Factors / administration & dosage,  adverse effects,  therapeutic use*
Injections, Subcutaneous
Interleukin-4 / administration & dosage,  adverse effects,  therapeutic use*
Lymphocyte Count / drug effects
Male
Middle Aged
Mouth Neoplasms / etiology,  immunology,  therapy*
Remission Induction
Sarcoma, Kaposi / etiology,  immunology,  therapy*
Skin Neoplasms / etiology,  immunology,  therapy*
Treatment Outcome
Viremia / etiology,  immunology,  therapy
Chemical
Reg. No./Substance:
0/HIV Core Protein p24; 0/Immunologic Factors; 207137-56-2/Interleukin-4

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