A pilot study of interleukin-2 for adult patients with acute myelogenous leukemia in first complete remission

Jorge E. Cortes, Hagop M. Kantarjian, Susan O'Brien, Francis Giles, Michael J. Keating, Emil J. Freireich, Elihu H. Estey

Research output: Contribution to journalArticle

Abstract

BACKGROUND. Interleukin-2 (IL-2) has immunomodulatory effects, including stimulating the activity of cytotoxic T cells and natural killer cells, and inducing the generation of lymphokine-activated killer cells. The authors investigated whether IL-2 may improve the duration of complete remission (CR) and survival in acute myelogenous leukemia (AML) patients in first CR. METHODS. Eighteen patients were included after achieving a CR and receiving at least two courses of consolidation chemotherapy. Therapy was comprised of IL-2 4.5 x 105 U/m2 daily by continuous infusion (CI) for 12 weeks, plus boluses of 1 x 106 U/m2 on Day 8 and weekly thereafter while continuing the CI. No further chemotherapy was given after the administration of IL-2 was started. RESULTS. The median age of the patients was 50 years (range, 18-73 years), and 7 patients (39%) had an antecedent hematologic disorder (AHD). The median CR duration was 12 months, with 6 patients still alive in CR at a median follow-up of 64 months (range, 50-82 months). Long term CR by cytogenetics occurred in 2 of 5 patients with a normal karyotype (CR duration of 68+ months and 72+ months, respectively), 1 of 3 patients with t(8;21) (CR duration of 82+ months), 1 patient with inv(16) (CR duration of 67+ months), none of 2 patients with -5/-7 (1 patient died in CR after 10 months), 1 of 2 patients with abnormalities in chromosome 11 (CR duration of 60+ months), and 1 of 4 patients with miscellaneous abnormalities (CR duration of 74+ months). The median survival was 47 months. To assess the significance of these results, the authors selected two historic controls receiving long term postremission chemotherapy per each IL-2 case. The controls had remained in CR for at least as long as the cases when the latter underwent treatment initiation with IL-2 and were matched for the number of induction courses required to achieve CR, AHD, cytogenetic abnormalities, and age. Six of 18 IL-2 patients (33%) were alive in CR at 3 years compared with 7 of 36 controls (19%) (P = 0.31). Nine IL-2 patients (50%) were alive at 3 years compared with 10 controls (28%) (P = 0.13). CONCLUSIONS. These results suggest that IL-2 is tolerable in AML patients in first CR and should be studied further in future studies as a therapeutic strategy to prolong remission duration.

Original languageEnglish (US)
Pages (from-to)1506-1513
Number of pages8
JournalCancer
Volume85
Issue number7
DOIs
StatePublished - Apr 1 1999
Externally publishedYes

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Acute Myeloid Leukemia
Interleukin-2
Consolidation Chemotherapy
Lymphokine-Activated Killer Cells
Drug Therapy
Chromosomes, Human, Pair 11
Survival
Karyotype
Cytogenetics
Chromosome Aberrations
Natural Killer Cells
Therapeutics

Keywords

  • Acute myeloid leukemia
  • Antecedent hematologic disorder
  • Interleukin-2
  • Maintenance

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

A pilot study of interleukin-2 for adult patients with acute myelogenous leukemia in first complete remission. / Cortes, Jorge E.; Kantarjian, Hagop M.; O'Brien, Susan; Giles, Francis; Keating, Michael J.; Freireich, Emil J.; Estey, Elihu H.

In: Cancer, Vol. 85, No. 7, 01.04.1999, p. 1506-1513.

Research output: Contribution to journalArticle

Cortes, Jorge E. ; Kantarjian, Hagop M. ; O'Brien, Susan ; Giles, Francis ; Keating, Michael J. ; Freireich, Emil J. ; Estey, Elihu H. / A pilot study of interleukin-2 for adult patients with acute myelogenous leukemia in first complete remission. In: Cancer. 1999 ; Vol. 85, No. 7. pp. 1506-1513.
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abstract = "BACKGROUND. Interleukin-2 (IL-2) has immunomodulatory effects, including stimulating the activity of cytotoxic T cells and natural killer cells, and inducing the generation of lymphokine-activated killer cells. The authors investigated whether IL-2 may improve the duration of complete remission (CR) and survival in acute myelogenous leukemia (AML) patients in first CR. METHODS. Eighteen patients were included after achieving a CR and receiving at least two courses of consolidation chemotherapy. Therapy was comprised of IL-2 4.5 x 105 U/m2 daily by continuous infusion (CI) for 12 weeks, plus boluses of 1 x 106 U/m2 on Day 8 and weekly thereafter while continuing the CI. No further chemotherapy was given after the administration of IL-2 was started. RESULTS. The median age of the patients was 50 years (range, 18-73 years), and 7 patients (39{\%}) had an antecedent hematologic disorder (AHD). The median CR duration was 12 months, with 6 patients still alive in CR at a median follow-up of 64 months (range, 50-82 months). Long term CR by cytogenetics occurred in 2 of 5 patients with a normal karyotype (CR duration of 68+ months and 72+ months, respectively), 1 of 3 patients with t(8;21) (CR duration of 82+ months), 1 patient with inv(16) (CR duration of 67+ months), none of 2 patients with -5/-7 (1 patient died in CR after 10 months), 1 of 2 patients with abnormalities in chromosome 11 (CR duration of 60+ months), and 1 of 4 patients with miscellaneous abnormalities (CR duration of 74+ months). The median survival was 47 months. To assess the significance of these results, the authors selected two historic controls receiving long term postremission chemotherapy per each IL-2 case. The controls had remained in CR for at least as long as the cases when the latter underwent treatment initiation with IL-2 and were matched for the number of induction courses required to achieve CR, AHD, cytogenetic abnormalities, and age. Six of 18 IL-2 patients (33{\%}) were alive in CR at 3 years compared with 7 of 36 controls (19{\%}) (P = 0.31). Nine IL-2 patients (50{\%}) were alive at 3 years compared with 10 controls (28{\%}) (P = 0.13). CONCLUSIONS. These results suggest that IL-2 is tolerable in AML patients in first CR and should be studied further in future studies as a therapeutic strategy to prolong remission duration.",
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T1 - A pilot study of interleukin-2 for adult patients with acute myelogenous leukemia in first complete remission

AU - Cortes, Jorge E.

AU - Kantarjian, Hagop M.

AU - O'Brien, Susan

AU - Giles, Francis

AU - Keating, Michael J.

AU - Freireich, Emil J.

AU - Estey, Elihu H.

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N2 - BACKGROUND. Interleukin-2 (IL-2) has immunomodulatory effects, including stimulating the activity of cytotoxic T cells and natural killer cells, and inducing the generation of lymphokine-activated killer cells. The authors investigated whether IL-2 may improve the duration of complete remission (CR) and survival in acute myelogenous leukemia (AML) patients in first CR. METHODS. Eighteen patients were included after achieving a CR and receiving at least two courses of consolidation chemotherapy. Therapy was comprised of IL-2 4.5 x 105 U/m2 daily by continuous infusion (CI) for 12 weeks, plus boluses of 1 x 106 U/m2 on Day 8 and weekly thereafter while continuing the CI. No further chemotherapy was given after the administration of IL-2 was started. RESULTS. The median age of the patients was 50 years (range, 18-73 years), and 7 patients (39%) had an antecedent hematologic disorder (AHD). The median CR duration was 12 months, with 6 patients still alive in CR at a median follow-up of 64 months (range, 50-82 months). Long term CR by cytogenetics occurred in 2 of 5 patients with a normal karyotype (CR duration of 68+ months and 72+ months, respectively), 1 of 3 patients with t(8;21) (CR duration of 82+ months), 1 patient with inv(16) (CR duration of 67+ months), none of 2 patients with -5/-7 (1 patient died in CR after 10 months), 1 of 2 patients with abnormalities in chromosome 11 (CR duration of 60+ months), and 1 of 4 patients with miscellaneous abnormalities (CR duration of 74+ months). The median survival was 47 months. To assess the significance of these results, the authors selected two historic controls receiving long term postremission chemotherapy per each IL-2 case. The controls had remained in CR for at least as long as the cases when the latter underwent treatment initiation with IL-2 and were matched for the number of induction courses required to achieve CR, AHD, cytogenetic abnormalities, and age. Six of 18 IL-2 patients (33%) were alive in CR at 3 years compared with 7 of 36 controls (19%) (P = 0.31). Nine IL-2 patients (50%) were alive at 3 years compared with 10 controls (28%) (P = 0.13). CONCLUSIONS. These results suggest that IL-2 is tolerable in AML patients in first CR and should be studied further in future studies as a therapeutic strategy to prolong remission duration.

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