Interleukin-2 and leukemia

Abstract

Leukemia has been treated with chemotherapy for the past 40 years with only moderate success. A growing body of evidence suggests that by augmenting the immune system more effective results may be obtained. This is highlighted by T cell reinfusions resulting in durable remissions in patients with chronic myelogenous leukemia who have relapsed after an allogeneic transplant. Interleukin-2 is the primary growth factor for T lymphocytes and is a stimulator of natural killer cell activity. It has now been shown that a limited number of otherwise refractory leukemias can be effectively treated with interleukin-2. However, there remains a lack of correlation between the biologic and clinical effects of interleukin-2. The clinical activity of interleukin-2 appears to be greatest in myeloid leukemias. A variety of dose schedules and routes of administration make it difficult to determine if interleukin-2 given to patients in clinical remission is of benefit. Large randomized studies are necessary to explore the role of interleukin-2 in leukemia.

CD8 T-cell responses to Wilms tumor gene product WT1 and proteinase 3 in patients with acute myeloid leukemia

“…4,5 HLA class I antigens, multiple adhesion molecules, and costimulatory molecules are expressed at high levels on AML blasts at diagnosis and at relapse. 6,7 These findings illustrate the potential for applying T-cell-based immunotherapy in the treatment of AML.…”

Role of cytokines in the treatment of acute leukemias: a review

“…66,67 Toxicity in the form of fever, hypotension, vascular leak, thrombocytopenia, rash, and sepsis has generally been acceptable, in particular for lower dose regimens. 69 Owing to the higher likelihood of efficacy of such biological therapy in patients with minimal residual disease, IL-2 has also been investigated as maintenance therapy in second or later remission, 70,71 or after autologous or allogeneic transplantation. [72][73][74][75][76][77] On the basis of the efficacy of IL-2 in these trials, it was hypothesized that the use of IL-2 in first CR might be relatively more beneficial.…”

BCR/ABL: from molecular mechanisms of leukemia induction to treatment of chronic myelogenous leukemia

“…This will only be briefly discussed and we refer the readers to excellent reviews that were recently published (Apperley et al, 1998;Campbell et al, 2001;Clark and Christmas, 2001;Claxton et al, 2001;Dazzi et al, 1999;Goodman et al, 1998;Pinilla-Ibarz et al, 2000b).…”