Aldesleukin

Aldesleukin Brand Name– Proleukin

What is Aldesleukin

Aldesleukin is recombinant formulation of interleukin-2 (IL-2).

Aldesleukin is a nonglycosylated biosynthetic interleukin-2 (also known as T-cell growth factor), which differs only slightly in amino acid sequence from the natural compound.

Interleukins function as molecular messengers between leukocytes. Given in its original dosing scheme as listed in the package insert, aldesleukin is highly toxic and should only be used in a hospital setting under the supervision of suitably qualified physicians experienced in the use of anti-cancer agents.

Because of its toxicity, extensive monitoring is required prior to and during therapy. Lower doses given subcutaneously can be safely administered in the home.

Aldesleukin is indicated for treating metastatic renal cell carcinoma and is currently being studied for treatment of acute myelogenous leukemia, non-Hodgkin’s lymphoma, HIV infection, leprosy as well as to maintain response following bone marrow transplantation.

In January 1999, aldesleukin was granted orphan drug status for the treatment of non-Hodgkin’s lymphoma and acute myelogenous leukemia.

Previously, aldesleukin had orphan drug designations for metastatic renal cell carcinoma, metastatic melanoma, and primary immunodeficiency disease with associated T-cell defects.

A randomized trial of aldesleukin in pediatric patients with AML is underway to determine the efficacy of aldesleukin to prevent AML relapse and a phase III trial for patients with HIV-associated lymphoma is being planned.

Aldesleukin was FDA approved in May 1992.

It was approved for the palliative treatment of metastatic melanoma in January 1998.

Indications

1. acute myelogenous leukemia (AML)
2. cutaneous T-cell lymphoma (CTCL)
3. graft-versus-host disease (GVHD)
4. leprosy (Hansen’s disease)
5. malignant melanoma
6. mycosis fungoides
7. renal cell cancer

For the treatment of metastatic renal cell cancer or metastatic malignant melanoma

Side Effects

1. abdominal pain
2. acute respiratory distress syndrome (ARDS)
3. agitation
4. anaphylactoid reactions
5. anemia
6. anemia
7. angina
8. angioedema
9. anorexia
10. antibody formation
11. anuria
12. anxiety
13. apnea
14. asthenia
15. ataxia
16. atrial fibrillation
17. AV block
18. bleeding
19. bowel necrosis
20. bradycardia
21. bullous rash
22. capillary leak syndrome
23. cardiac arrest
24. cardiac tamponade
25. cardiomyopathy
26. cerebral edema
27. chest pain (unspecified)
28. chills
29. cholecystitis
30. coagulopathy
31. colitis
32. coma
33. confusion
34. confusion
35. cough
36. delirium
37. depression
38. diabetes mellitus
39. diarrhea
40. diarrhea
41. dizziness
42. drowsiness
43. dyspnea
44. dyspnea
45. edema
46. elevated hepatic enzymes
47. elevated hepatic enzymes
48. encephalopathy
49. eosinophilia
50. exfoliative dermatitis
51. fever
52. fever
53. gastritis
54. GI bleeding
55. GI obstruction
56. GI perforation
57. glomerulonephritis
58. hallucinations
59. heart failure
60. hematemesis
61. hepatic failure
62. hepatitis
63. hepatomegaly
64. hyperbilirubinemia
65. hyperbilirubinemia
66. hyperglycemia
67. hypertension
68. hyperthyroidism
69. hyperuricemia
70. hypocalcemia
71. hypomagnesemia
72. hypotension
73. hypotension
74. hypothermia
75. hypothyroidism
76. hypoxia
77. infection
78. infection
79. injection site reaction
80. insomnia
81. interstitial nephritis
82. intracranial bleeding
83. irritability
84. lethargy
85. leukocytosis
86. leukopenia
87. leukopenia
88. malaise
89. malignant hyperthermia
90. metabolic acidosis
91. metabolic acidosis
92. myasthenia
93. myocardial infarction
94. myocarditis
95. myopathy
96. nausea
97. neuritis
98. neutropenia
99. oliguria
100. optic neuritis
101. palpitations
102. pancreatitis
103. paranoia
104. pericardial effusion
105. pericarditis
106. peripheral edema
107. peripheral vasodilation
108. phlebitis
109. pruritus
110. psychosis
111. pulmonary edema
112. pulmonary embolism
113. rash
114. renal failure (unspecified)
115. renal tubular necrosis
116. respiratory arrest
117. retroperitoneal bleeding
118. rhabdomyolysis
119. rhinitis
120. seizures
121. sinus tachycardia
122. splenomegaly
123. Stevens-Johnson syndrome
124. stomatitis
125. supraventricular tachycardia (SVT)
126. supraventricular tachycardia (SVT)
127. syncope
128. tachypnea
129. thrombocytopenia
130. thrombocytopenia
131. thrombosis
132. tissue necrosis
133. tracheoesophageal fistula
134. urticaria
135. vasculitis
136. ventricular tachycardia
137. visual impairment
138. vomiting
139. vomiting
140. weight gain

Monitoring Parameters

• arterial blood gases (ABGs)
• CBC with differential
• chest x-ray
• ejection fraction
• LFTs
• platelet count
• serum electrolytes
• serum lipid profile
• thallium stress test
• weight

Contraindications

• angina
• autoimmune disease
• breast-feeding
• capillary leak syndrome
• cardiac arrhythmias
• cardiac disease
• cardiac tamponade
• children
• coma
• Crohn’s disease
• diabetes mellitus
• geriatric
• GI bleeding
• GI perforation
• hepatic disease
• infants
• infection
• lethargy
• mental status changes
• myasthenia gravis
• myocardial infarction
• neonates
• organ transplant
• pregnancy
• psychosis
• pulmonary disease
• renal disease
• renal failure
• renal impairment
• requires a specialized care setting
• requires an experienced clinician
• respiratory insufficiency
• scleroderma
• seizure disorder
• seizures
• thyroid disease
• vaccination
• vasculitis
• ventricular tachycardia

Interactions

• Acebutolol
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Codeine
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• Aspirin, ASA; Oxycodone
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