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Table 1 Institutional guidelines - relative and absolute criteria for discontinuation of IL-2 therapy

From: Clinical characteristics and treatment-related biomarkers associated with response to high-dose interleukin-2 in metastatic melanoma and renal cell carcinoma: retrospective analysis of an academic community hospital’s experience

System Relative criteria Absolute criteria
Cardiac Sinus tachycardia, HR 120 – 130 Sinus tachycardia, HR >130
EKG Ischemia
Atrial Fibrillation
   Frequent PVCs, bigeminy, ventricular arrhythmia
Elevated cardiac enzymes
Dermatologic   Moist desquamation
Gastrointestinal Diarrhea >1000cc/shift Refractory vomiting
Unrelenting abdominal pain
Abdominal distension
Hemodynamic   Hypotension requiring pressors
Hemorrhage Guiac-positive stool, sputum or emesis Frank blood in stools, sputum or emesis
Platelets 30,000 – 50,000/mm3
Platelets < 30,000/mm3
Infectious   Strong clinical suspicion or documented
Neurologic   Mental status changes
Disorientation, vivid dreams, emotional lability
Pulmonary Resting dyspnea >4 L oxygen needed for saturations >95%
Crackles present in >1/3 but <1/2 chest Crackles present in >1/2 chest
40% oxygen mask for saturations >95%
3 – 4 L oxygen for saturations > 95%
Intubation
Renal Urine output 80 – 160 mL/8 hour Urine <80 mL/8 hour
Urine < 10 mL/hour
Creatinine ≥ 3 mg/dL
Urine 10 – 20 mL/hour
Creatinine 2.5 – 2.9 mg/dL
Weight Gain 15% over baseline  
  1. In the occurrence of any relative criteria the dose is held, corrective action taken and patient re-assessed at next scheduled time. Discontinue therapy if ≥ 3 relative criteria occur or for any one absolute criteria. Discontinue therapy if pressors are needed for hypotension, neurological changes or the scheduled dose has been held on 3 occasions.
  2. HR = heart rate, EKG = electrocardiogram, PVC = premature ventricular contraction).
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