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Care During Chemotherapy and Beyond

Aldesleukin

(al-des-LOO-kin)

Trade name:Proleukin®

Other names:Interleukin-2, IL-2

Aldesleukin is the generic name for the trade drug names Proleukin. Interleukin-2 and IL-2 are other names for Aldesleukin. In some cases, health care professionals may use the trade name Proleukin or other names Interleukin-2 and IL-2 when referring to the generic drug name Aldesleukin.

Drug type: Aldesleukin is an "antineoplastic (anticancer) biologic response modifer." Aldesleukin is classified as a "cytokine." (For more detail, see "How this drug works" section below).

What Aldesleukin is used for:

  • Metastatic renal cell carcinoma (kidney)
  • Metastatic melanoma

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Aldesleukin is given:

  • Aldesleukin has been approved for cancer treatment with a high-dose regimen, but it may also be administrered in a low-dose form.
  • The high-dose regimen involves giving the drug intravenously (into a vein) every 8 hours, as tolerated, for up to 14 doses. There 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.
  • A low dose regimen is also available for certain types of cancers. "Low-dose interleukin-2" is administered on an outpatient basis. Low-dose interleukin-2 is usually given as a shot under the skin (subcutanuous injection, SubQ). In some situations, patients may be able to give themselves these injections at home.
  • There is no pill form of Aldesleukin

The amount of Aldesleukin that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact dosage and schedule.

Side effets of Aldesleukin:

Important things to remember about the side effects of Aldesleukin:

  • Most people will not experience all of the side effects listed.
  • Aldesleukin's side effects are often predictable in terms of their onset, duration and severity.
  • Aldesleukin's side effects will improve after therapy is complete.
  • Aldesleukin's side effects may be quite manageable. There are many options to minimize or prevent the side effects of Aldesleukin

The following are common (occurring in greater than 30%) side effects for patients taking Aldesleukin:

The following are less common (occuring in 10 to 29%) side effects for patients taking Aldesleukin:

A serious, but very uncommon side effect of Aldesleukin 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 follow 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 Aldesleukin. 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 (occuring 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 time frame 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).
  • Severe dizziness
  • Mouth sores (painful redness, swelling, or ulcers)
  • Unusual bruising or severe rash

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

  • Before starting Aldesleukin 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 products containing aspirin unless your doctor specifically permits this.
  • For up to several months after Aldesleukin 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 Aldesleukin.
  • 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 Aldesleukin. 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 management of chills, keep warm with blankets and drink plenty of liquids.
  • 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.
  • Wash your hands often.
  • Use an electric razor to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • Avoid sun exposure. Wear SPF 30 (or higher) sunblock and protective clothing.
  • In general, drinking alcoholic beverages should be minimized or avoided. You should discuss this with your doctor.
  • Follow regimen of anti-diarrhea medication as prescribed by your health care professional.
  • Eat foods that may help reduce diarrhea (see managing side effects - diarrhea)
  • 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.
  • Get plenty of rest.
  • Remain as active as you are able. Gentle exercise is encouraged such as a daily walk.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or off other suggestions that are effective in managing such problems.

Monitoring and testing:

You will be checked regularly by your doctor while you are taking Aldesleukin, to monitor side effects and check your reponse to therapy. Prior to starting Aldesleukin you may receive a stress thallium study to assess your heart. Periodic blood work will be obtained to monitor your complete blood count (CBC), as well as the function of other organs (such as your kidney and liver) will also be ordered by your doctor. Your blood pressure and weight will be recorded as well.

How Aldesleukin works:

Aldesleukin is classified as a "biologic response modifier (BRM)" or "biologic therapy." BRMs modify the body's response to cancer cells, and hopefully improve the body's natural response to infection and disease. Interleukin-2 is a part of a family of proteins called cytokines. Cytokines act primarily by communicating between the various cells of the body's immune system.

Aldesleukin 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.

Aldesleukin 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.

Reference:

Aldesleukin. Lexicomp Online® [updated 2015 Sep 1; cited 2015 Sep 10]. Lexi-Drugs®. Hudson, Ohio: Lexi-Comp, Inc.; Sep10, 2015.

Proleukin (aldesleukin) [package insert on the Internet]. San Diego (CA): Prometheus Laboratories Inc.; 2010 [updated 2015 Jan; cited 2015 Sep 10]. Available from: http://www.proleukin.com/assets/proleukin.pdf

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