PERIPHERAL-NERVE ENTRAPMENT - AN UNUSUAL ADVERSE EVENT WITH HIGH-DOSEINTERLEUKIN-2 THERAPY

Recombinant interleukin 2 (rIL-2) is a promising biological therapy ag ent in the treatment of patients with metastatic renal cell carcinoma and metastatic melanoma [1, 2]. The antitumor effects are a result of a complex interplay of generation of NX and T-cells and secretion of a variety of lymphokines (IFN, IL6 and TNF) [3]. Early studies and succ ess with rIL-2 were reported with the high dose intravenous bolus admi nistration regimen [4-6]. High dose rIL-2 therapy is associated with s ignificant morbidity [7], which is primarily related to the vascular l eak syndrome (VLS) [8] and effects all the major organ systems; predom inantly the cardiovascular, renal, gastrointestinal, hematological and central nervous system. Neurological involvement is usually in the fo rm of restlessness, confusion, disorientation and rarely convulsions [ 7]. Peripheral nervous system involvement is uncommon, and has been pr eviously reported to present as a nerve entrapment syndrome [9]. We ha ve observed the same adverse effect with two of our patients undergoin g rIL-2 therapy for renal cell carcinoma and malignant melanoma.