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Care During Chemotherapy and Beyond
Generic name: Aldesleukin
Trade name: Proleukin
®
Other names: IL-2
Proleukin is the trade name for the generic drug name Aldesleukin. IL-2 and Interleukin-2
are other names for Aldesleukin. In some cases, health care professionals may use
the trade name Proleukin or other names IL-2 and Interleukin-2 when referring to
the generic drug name Aldesleukin.
Drug type: Interleukin-2 is a "biologic response modifier." Interleukin-2
is classified as a "cytokine." (For more detail, see "How this drug works" section
below).
What Interleukin-2 Is Used For:
- Cancers treated with Interleukin-2 include renal cell (kidney) and melanoma, a skin
cancer.
Note: If a drug has been approved for one use, physicians
sometimes elect to use this same drug for other problems if they believe it may
be helpful.
How Interleukin-2 Is Given:
Interleukin-2 has been approved for cancer treatment with a high-dose regimen, but
it may also be administered in a low-dose form. The high-dose regimen involves
giving the drug intravenously (into a vein) every eight hours, as tolerated, for
up to 15 doses. There are significant side effects with this regimen (though
they are reversible once treatment is stopped). Because of the severity of
these side effects, patients are hospitalized and sometimes need intensive care
unit support while the drug is being given.
In order to lessen these side effects, an alternate, low-dose regimen was developed.
"Low-dose interleukin-2" is administered on an outpatient basis. Low-dose
interleukin-2 is usually given as a shot under the skin (subcutaneous injection,
SubQ). In some situations, patients may be able to give themselves these injections
at home.
Side Effects:
Important things to remember about the side effects of Interleukin-2:
- Most people do not experience all of the side effects listed.
- Side effects are often predictable in terms of their onset, duration and severity.
- Side effects are almost always reversible and will go away after treatment is complete.
- There are many options to help minimize or prevent side effects.
- There is no relationship between the presence or severity of side effects and the
effectiveness of the medication
- Interleukin-2's side effects and their severity depend on how much of the drug is
given. In other words, high doses may produce more severe side effects.
In some cases, this could necessitate hospitalization and/or intensive care unit
support.
The following are common (occurring in greater than 30%) side effects for
patients taking Interleukin-2:
- Fever and chills or flu-like symptoms. The severity decreases over time, particularly
in low-dose regimens.
- Generalized flushing (redness) of the face and body, or skin rash (All patients
on high-dose therapy will experience this effect) (see skin reactions).
- Nausea or vomiting
- Lowered blood pressure
- Diarrhea
- Low blood counts. Your white and red blood cells and platelets may temporarily
decrease in number. This can put you at increased risk for infection, anemia
and/or bleeding.
- Changes in mental status, such as confusion, drowsiness or memory loss.
- Fast heartbeats (tachycardia) (see heart problems).
- Lowered urine output.
- Changes in liver function (see liver problems).
- Generalized aches and pains (see pain).
- Swelling of the face, ankles or legs (edema or water retention).
The following are less common (occurring in 10 to 29%) side effects for
patients taking Interleukin-2:
- Respiratory congestion or breathing difficulty (see lung problems).
- Itching
- Low blood counts (low white blood cells)
- Mouth sores
- Poor appetite
- Fatigue
- Weight gain or loss
- Infection
- Irregular heartbeats (see heart problems).
- Dizziness.
- Dry or peeling skin (see skin reactions)
- Injection site reactions (with subcutaneous, or under the skin, injections)
A serious, but very uncommon side effect of Interleukin-2 in high doses is "capillary
leak syndrome" or "vascular leak syndrome." Capillary leak syndrome is a potentially
serious disease in which fluids within the vascular system (veins and capillaries)
leaks into the tissue outside the bloodstream. This results in low blood pressure
and poor blood flow to the internal organs. Capillary leak syndrome is characterized
by the presence of 2 or more of the following 3 symptoms; low blood pressure, swelling,
and low levels of protein in the blood. Your doctor will monitor these things
carefully while you are taking Interleukin-2. You should notify your
doctor immediately if you notice dizziness (especially when changing position),
sudden swelling or rapid weight gain, little or no urine output (for 8-12 hours),
shortness of breath, difficulty breathing, irregular heartbeats, or chest pain.
Not all side effects are listed above, some that are rare (occurring in less than
10% of patients) are not listed here. However, you should always inform your
health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you
should experience any of the following symptoms:
- Wheezing or difficulty breathing
- Dizziness (especially when changing position), sudden swelling or rapid weight gain,
little or no urine output (for 8-12 hours), shortness of breath, difficulty breathing,
irregular heartbeats or chest pain.
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours of noticing any of the
following:
- Anxiety, changes in thinking or mood, confusion, difficulty concentrating or trouble
sleeping.
- Diarrhea (more than 4 to 6 episodes in a 24-hour period).
- Nausea that interferes with eating and is not relieved by medications prescribed
by your doctor.
- Vomiting (more than 4 to 5 episodes within a 24-hour period).
- Sustained fever (fever lasting/occurring beyond the expected timeframe for dose
and schedule).
- Unusual bleeding or bruising.
- Black or tarry stools, or blood in your stools or urine.
- Extreme fatigue (unable to perform self-care activities).
In addition, call your health care provider if any side effects become continuous,
serious or your condition worsens.
Precautions:
- Before starting aldesleuken treatment, make sure you tell your doctor about any
other medications you are taking (including over-the-counter medications, vitamins
or herbal remedies). Do not take aspirin, or products containing aspirin,
unless your doctor permits this.
- For up to several months after Interleukin-2 treatment has ended, patients may have
a reaction to the iodine-containing contrast material used for CT scans. These
reactions may include fever, chills, nausea and vomiting, itching, rash, diarrhea
or swelling.
- Do not receive any kind of vaccination without your doctor's approval while taking
Interleukin-2.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category C (use in pregnancy only when
benefit to mother outweighs risk to fetus).
- For both men and women: Do not conceive a child (get pregnant) while taking aldesleuken.
Barrier methods of contraception, such as condoms, are recommended. Discuss with
your doctor when you may safely become pregnant or conceive a child after therapy.
- Do not breast-feed while taking this medication.
Self-Care Tips:
- For flu-like symptoms, keep warm with blankets and drink plenty of liquids.
There are medications that can help reduce the discomfort caused by chills.
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
otherwise.
- To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times
a day with 1/2 - 1 teaspoon of baking soda or salt mixed with 8 ounces of water.
- Patients receiving injections under the skin may develop pain and hard bumps at
the injection sites. These reactions are normal. Pain will go away within
minutes, although the bumps may remain for a few months after therapy. Changing
the sites of the injections, and using warm or cold compresses are helpful.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and
eat small, frequent meals.
- Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
- In general, drinking alcoholic beverages should be minimized or avoided. You
should discuss this with your doctor.
- Wash your hands often.
- You may be at risk of infection so try to avoid crowds or people with colds, and
report fever or any other signs of infection immediately to your healthcare provider.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that
are effective in managing such problems.
Monitoring and Testing:
Before starting treatment with Interleukin-2, your doctor will perform a physical
exam. Blood tests and often-other types of tests, as decided by your doctor,
will be used to evaluate the function of your major organs (heart, lungs, kidneys
and liver). Throughout your therapy, your doctor will see you regularly to
assess any changes in your blood pressure, weight and level of fatigue, and to discuss
side effects. The doctor will order blood tests and other tests as needed
to monitor side effects and check your response to therapy.
How Interleukin-2 Works:
Interleukin-2 is classified as a "biologic response modifier (BRM)" or "biologic
therapy." BRMs modify the body's response to cancer cells. Interleukin-2 is
part of a family of proteins called cytokines. Cytokines act primarily by
communicating between the various cells of the body's immune system.
Interleukin-2 helps increase production of several different components of the immune
system found in the blood, including T lymphocytes and natural killer cells.
It also may improve the function of other immune system cells, such as lymphokine-activated
killer cells and tumor-infiltrating lymphocytes. This helps the body fight
cancer.
Interleukin-2 is a synthetic form of interleukin-2, a protein that the body produces
naturally. Interleukin-2 was discovered more than 20 years ago. The U.S. Food
and Drug Administration approved it in its synthetic form for treatment against
cancer in 1992.
Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
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