PURPOSE: To determine the disease-free survival (DFS) and toxicity of administering interleukin-2 (IL-2) immunotherapy early after autologous stem-cell transplantation (ASCT) to simulate a graft versus leukemia effect observed in allogeneic transplantation. PATIENTS AND METHODS: Fifty-six patients with acute myeloid leukemia in first remission received a single consolidation of high-dose cytarabine-idarubicin at a median of 1.1 month postremission with the intent to proceed to ASCT and IL-2 9 x 10(6) U/m(2)/24 h for 4 days, followed by 10 days of IL-2 1.6 x 10(6) U/m(2)/24 h on hematologic recovery. RESULTS: Eighty-four percent of patients received the intended ASCT, and 68% of patients received IL-2 treatment. With a median follow-up of 39.4 months (range, 1.2 to 76.3 months), the 2-year cumulative probability of DFS for all 56 patients is 68% (95% confidence interval [CI], 55% to 80%) and 74% (95% CI, 57% to 85%) for the 39 patients undergoing IL-2 treatment after ASCT. The 2-year cumulative probability of DFS for favorable, intermediate, and unfavorable cytogenetics is 88% (95% CI, 59% to 97%), 48% (95% CI, 26% to 67%), and 70% (95% CI, 23% to 93%), respectively. Toxicities from IL-2 were mainly thrombocytopenia, leukopenia, fever, and fluid retention. Two septic deaths occurred during neutropenia, which includes one during consolidation and one during transplant, for an overall 4% mortality rate. CONCLUSION: These results suggest that a moderate dose of IL-2 after high-dose cytarabine-idarubicin-mobilized ASCT is associated with a low regimen-related toxicity and may improve DFS. A phase III study of IL-2 is now warranted.
PURPOSE: To determine the disease-free survival (DFS) and toxicity of administering interleukin-2 (IL-2) immunotherapy early after autologous stem-cell transplantation (ASCT) to simulate a graft versus leukemia effect observed in allogeneic transplantation. PATIENTS AND METHODS: Fifty-six patients with acute myeloid leukemia in first remission received a single consolidation of high-dose cytarabine-idarubicin at a median of 1.1 month postremission with the intent to proceed to ASCT and IL-2 9 x 10(6) U/m(2)/24 h for 4 days, followed by 10 days of IL-2 1.6 x 10(6) U/m(2)/24 h on hematologic recovery. RESULTS: Eighty-four percent of patients received the intended ASCT, and 68% of patients received IL-2 treatment. With a median follow-up of 39.4 months (range, 1.2 to 76.3 months), the 2-year cumulative probability of DFS for all 56 patients is 68% (95% confidence interval [CI], 55% to 80%) and 74% (95% CI, 57% to 85%) for the 39 patients undergoing IL-2 treatment after ASCT. The 2-year cumulative probability of DFS for favorable, intermediate, and unfavorable cytogenetics is 88% (95% CI, 59% to 97%), 48% (95% CI, 26% to 67%), and 70% (95% CI, 23% to 93%), respectively. Toxicities from IL-2 were mainly thrombocytopenia, leukopenia, fever, and fluid retention. Two septic deaths occurred during neutropenia, which includes one during consolidation and one during transplant, for an overall 4% mortality rate. CONCLUSION: These results suggest that a moderate dose of IL-2 after high-dose cytarabine-idarubicin-mobilized ASCT is associated with a low regimen-related toxicity and may improve DFS. A phase III study of IL-2 is now warranted.
Authors: Marc Buyse; Pierre Squifflet; Beverly J Lange; Todd A Alonzo; Richard A Larson; Jonathan E Kolitz; Stephen L George; Clara D Bloomfield; Sylvie Castaigne; Sylvie Chevret; Didier Blaise; Dominique Maraninchi; Kathryn J Lucchesi; Tomasz Burzykowski Journal: Blood Date: 2011-04-25 Impact factor: 22.113
Authors: Beverly J Lange; Richard K Yang; Jacek Gan; Jaquelyn A Hank; Eric L Sievers; Todd A Alonzo; Robert B Gerbing; Paul M Sondel Journal: Pediatr Blood Cancer Date: 2011-06-16 Impact factor: 3.167
Authors: J de la Rubia; G Martín; J Martínez; I Lorenzo; G Sanz; I Jarque; F Moscardó; C Jiménez; P Lorente; A Camps; M A Sanz Journal: Int J Hematol Date: 2004-08 Impact factor: 2.490
Authors: Cyrus Khandanpour; Christian Thiede; Peter J M Valk; Ehssan Sharif-Askari; Holger Nückel; Dietmar Lohmann; Bernhard Horsthemke; Winfried Siffert; Andreas Neubauer; Karl-Heinz Grzeschik; Clara D Bloomfield; Guido Marcucci; Kati Maharry; Marilyn L Slovak; Bert A van der Reijden; Joop H Jansen; Hans K Schackert; Khashayar Afshar; Susanne Schnittger; Justine K Peeters; Frank Kroschinsky; Gerhard Ehninger; Bob Lowenberg; Ulrich Dührsen; Tarik Möröy Journal: Blood Date: 2010-01-14 Impact factor: 22.113