Purpose: Cancer and Leukemia Group B (CALGB) 9720 evaluated subcutaneous low-dose recombinant interleukin-2 (rIL-2) maintenance immunotherapy as a strategy for prolonging remission in older patients with acute myeloid leukemia (AML).
Patients And Methods: AML patients age 60 years and older in first complete remission after induction and consolidation chemotherapy were randomly assigned to no further therapy or a 90-day regimen of 14-day cycles of low-dose rIL-2, aimed at expanding natural killer (NK) cells, followed by 3-day higher doses aimed at activating cytotoxicity of expanded NK cells to lyse residual AML cells. All randomly assigned patients were included in an intention-to-treat analysis.
Results: A total of 163 (64%) of 254 patients who completed induction and consolidation chemotherapy on CALGB 9720 were randomly assigned to rIL-2 (n = 81) or no further therapy (n = 82); the most common reasons for lack of random assignment were patient refusal and relapse. Fifteen patients randomly assigned to rIL-2 never initiated it because of refusal, intercurrent medical problems, or relapse, and 24 patients initiated rIL-2 but stopped early because of toxicity or relapse. Grade 4 toxicities during rIL-2 therapy included thrombocytopenia (65%) and neutropenia (64%), and grade 3 toxicities included anemia (33%), infection (24%) and malaise/fatigue (14%). Forty-two patients (52%) randomly assigned to rIL-2 completed the full 90-day course. Patients in both arms had similar distributions of both disease-free (combined median = 6.1 months; P = .47) and overall survival (combined median = 14.7 months; P = .61) after random assignment. Moreover, the 42 patients who completed all planned therapy did not show prolongation of disease-free or overall survival.
Conclusion: Low-dose rIL-2 maintenance immunotherapy is not a successful strategy in older AML patients.
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http://dx.doi.org/10.1200/JCO.2008.17.0472 | DOI Listing |
Alzheimers Dement (N Y)
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Department of Health Economics and Health Services Research, Hamburg Center for Health Economics University Medical Center Hamburg-Eppendorf Hamburg Germany.
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Indian J Crit Care Med
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Department of Anesthesia and ICU, Ain Shams University, Cairo, Egypt.
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Department of Breast Surgery, The Rotherham NHS Foundation Trust, Rotherham, GBR.
Background The sentinel lymph node biopsy (SLNB) is the standard method used to determine the stage of breast cancer in patients with no clinical signs of axillary involvement. The current gold standard for the intraoperative assessment of the axilla involves the use of dual radioisotope and patent blue dye. However, researchers have been studying the use of superparamagnetic iron oxide Magtrace® (Endomagnetics Limited, Cambridge, United Kingdom) agents as an alternative to overcome the limitations of the standard SLNB technique.
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Department of Sport Education, Hunan Normal University, Changsha, China.
Background: China has a significant population of left-behind children, defined as those whose parents have migrated away from their home for at least six months. This situation arises when one or both parents leave to seek work in urban areas. Among the various challenges faced by left-behind children, social anxiety has emerged as one of the most pressing issues.
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