THE NEUROPSYCHIATRIC EFFECTS OF TREATMENT WITH INTERLEUKIN-2 AND LYMPHOKINE-ACTIVATED KILLER-CELLS
THE NEUROPSYCHIATRIC EFFECTS OF TREATMENT WITH INTERLEUKIN-2 AND LYMPHOKINE-ACTIVATED KILLER-CELLS
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DOI：
10.7326/0003-4819-107-2-293
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发表时间：
1987-09-01
影响因子：
39.2
通讯作者：
ROSENBERG, SA
中科院分区：
文献类型：
--
作者：
DENICOFF, KD;RUBINOW, DR;ROSENBERG, SA
研究目的：研究白细胞介素-2 和淋巴因子激活杀伤细胞治疗的神经精神表现。设计：对接受治疗的连续患者进行纵向调查。每个患者在治疗前 5 天内都会接受初步访谈，并在第一次访谈期间获得个人和家庭精神病史。在白介素 2 和淋巴因子激活杀伤细胞治疗开始和结束时、出院前以及出院后 2 至 4 周的随访时进行认知测试和情绪自评仪器。地点：美国国立卫生研究院的国家癌症研究所住院部。患者或其他参与者：44名转移性癌症患者（年龄范围28至69岁）的连续样本，这些患者在1985年12月30日至1986年3月31日期间接受了重组白细胞介素-2联合自体淋巴因子激活的杀伤细胞的系统治疗。测量和主要结果：在所研究的44名患者中，15名出现了需要紧急干预的严重行为变化，22名患者出现了严重的认知变化（所有22 人变得迷失方向，许多人还有认知恶化的心理测量证据）。神经精神副作用与剂量和时间相关，在较高剂量时出现更频繁，并且在每个治疗阶段结束时几乎一致。所有 39 名随访患者的认知评分均恢复至基线水平。没有发现所研究的因素可以预测神经精神毒性的发生。结论：在使用白细胞介素 2 和淋巴因子激活的杀伤细胞期间，临床上显着的神经精神变化的发生很常见，并且可能限制治疗。几乎所有患者在治疗开始后都发现神经精神变化出现明显的潜伏期。每一位接受研究的患者都从神经精神副作用中康复。
Study Objective: To study the neuropsychiatric manifestations of therapy with interleukin-2 and lymphokine-activated killer cells. Design: Longitudinal survey of consecutive patients who were given the treatment. Each patient was initially interviewed within 5 days before treatment, and a personal and family psychiatric history was obtained during this first session. Cognitive tests and mood self-rating instruments were administered at the beginning and end of interleukin-2 and lymphokine-activated killer cell treatments, before discharge, and at a follow-up visit 2 to 4 weeks after discharge. Setting: National Cancer Institute inpatient units at the National Institutes of Health. Patients or Other Participants: Sequential samples of 44 patients with metastatic cancer (age range, 28 to 69 years) who were treated systematically with recombinant interleukin-2 combined with autologous lymphokine-activated killer cells between 30 December 1985 and 31 March 1986. Measurements and Main Results: Of the 44 patients studied, 15 developed severe behavioral changes that necessitated acute intervention, and 22 patients had severe cognitive changes (all 22 became disoriented and many also had psychometric evidence of cognitive deterioration). The neuropsychiatric side effects were dose and time related, appearing more frequently at the higher dose and almost uniformly at the end of each treatment phase. All 39 patients who were seen at follow-up had a return to their baseline cognitive scores. None of the factors investigated was found to be predictive of the development of neuropsychiatric toxicity. Conclusions: The development of clinically significant neuropsychiatric changes during the administration of interleukin-2 and lymphokine-activated killer cells was common and may be treatment limiting. A marked latency in the appearance of neuropsychiatric changes after treatment onset was noted in almost all patients. Every patient studied recovered from the neuropsychiatric side effects.