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Soluble interleukin‐2 receptor α activation in a Children's Oncology Group randomized trial of interleukin‐2 Therapy for Pediatric Acute Myeloid Leukemia
Author(s) -
Lange Beverly J.,
Yang Richard K.,
Gan Jacek,
Hank Jaquelyn A.,
Sievers Eric L.,
Alonzo Todd A.,
Gerbing Robert B.,
Sondel Paul M.
Publication year - 2011
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22966
Subject(s) - medicine , myeloid leukemia , chemotherapy , randomized controlled trial , gastroenterology , interleukin 2 , complete remission , myeloid , leukemia , oncology , receptor
Abstract Purpose To assess associations of soluble IL‐2 receptor alpha (sIL‐2rα) concentration with outcomes in pediatric acute myeloid leukemia (AML) in a phase 3 trial of IL‐2 therapy. Procedures We randomized 289 children with AML in first remission after intensive chemotherapy to receive IL‐2 infused on days 0–3 and 8–17 (IL‐2 group) or no further therapy (AML control group). We measured sequential serum sIL‐2rα concentrations in both groups before, during and after therapy in both groups and in reference controls without AML. Results Before treatment, mean sIL‐2rα concentrations were similar in the IL‐2 group and AML controls, but significantly higher than in reference controls. Both AML groups experienced reduction in sIL‐2rα concentration after chemotherapy. Thereafter in the IL‐2 group, mean sIL‐2rα concentration increased from 2,669 pg/ml before IL‐2 to 15,534 pg/ml on day 4 ( P < 0.001) and 10,585 pg/ml on day 18 ( P < 0.001). In the control group sIL‐2rα concentration did not change after 28 days of follow‐up. Five‐year disease‐free survival (DFS) was 51% in the IL‐2 group and 58% in the controls ( P = 0.489) and overall survival was 70% and 73%, respectively ( P = 0.727). Conclusion SIL‐2rα concentration was elevated in AML at diagnosis and tended to normalize after chemotherapy. IL‐2 infusion significantly increased sIL‐2rα concentration, but did not improve DFS or survival in pediatric AML. Furthermore, sIL‐2rα concentration was not predictive of outcome before, during or after treatment for AML. Pediatr Blood Cancer 2011; 57: 398–405. © 2011 Wiley‐Liss, Inc.