Marion Corfmat1, Christophe Willekens2, Julien Vinit3, Guillaume Bussone4, Pierre Fenaux5, Olivier Fain6, David Klatzmann7,8, Arsene Mekinian6, Thibault Comont1,9. 1. Service de Médecine Interne, IUCT Oncopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse. 2. Département d'Hématologie, Institut Gustave Roussy, Université Paris Sud, Villejuif. 3. Service de Médecine Interne, CHWM, 4, Rue Capitaine-Drillien, Chalon-sur-Saône. 4. Service de Médecine Interne, Immunologie Clinique, Médecine Aigüe Polyvalente, Hôpital Antoine-Béclère-AP-HP, Clamart. 5. Service d'Hématologie Séniors Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université de Paris. 6. Service de Médecine Interne, AP-HP, Hôpital Saint Antoine, Sorbonne Université. 7. INSERM, Immunology-Immunopathology-Immunotherapy (i3), Sorbonne Université. 8. Clinical Investigation Center for Biotherapies (CIC-BTi) and Immunology-Inflammation-Infectiology and Dermatology Department (3iD), AP-HP, Hôpital Pitié-Salpêtrière, Paris. 9. Centre de Recherche en Cancérologie de Toulouse, Inserm UMR 1037, Toulouse, France.
Abstract
OBJECTIVES: Systemic inflammatory and autoimmune diseases can be associated with myelodysplastic syndromes. Current treatments (steroids, immunosuppressive agents, biologics) are unsatisfactory because of their low response rate, dependence or adverse events. We aimed at evaluating the effects of low doses of IL-2 (ld-IL2) as a regulatory T-cell inducer in this context. METHODS: We treated three patients with ld-IL2 with myelodysplastic syndromes and an associated dysimmune disorder (polymyalgia rheumatic, relapsing polychondritis associated with Sweet's syndrome and vasculitis with cutaneous and joint involvement, respectively). All three patients were dependent on steroids and refractory to biologics or azacitidine. They received doses of 1-1.5 million units of proleukin/day during 5 days and then every fortnight. RESULTS: The treatment led to a clinical improvement and steroid sparing in 2/3 patients with no serious adverse events, and no progression of the disease. CONCLUSION: Our results support the investigation of ld-IL2 in MDS associated with immune disorders in controlled clinical studies.
OBJECTIVES: Systemic inflammatory and autoimmune diseases can be associated with myelodysplastic syndromes. Current treatments (steroids, immunosuppressive agents, biologics) are unsatisfactory because of their low response rate, dependence or adverse events. We aimed at evaluating the effects of low doses of IL-2 (ld-IL2) as a regulatory T-cell inducer in this context. METHODS: We treated three patients with ld-IL2 with myelodysplastic syndromes and an associated dysimmune disorder (polymyalgia rheumatic, relapsing polychondritis associated with Sweet's syndrome and vasculitis with cutaneous and joint involvement, respectively). All three patients were dependent on steroids and refractory to biologics or azacitidine. They received doses of 1-1.5 million units of proleukin/day during 5 days and then every fortnight. RESULTS: The treatment led to a clinical improvement and steroid sparing in 2/3 patients with no serious adverse events, and no progression of the disease. CONCLUSION: Our results support the investigation of ld-IL2 in MDS associated with immune disorders in controlled clinical studies.