Vascular leak syndrome: A side effect of immunotherapy

Roxana Baluna, Ellen S. Vitetta

Research output: Contribution to journalArticle

198 Citations (Scopus)

Abstract

The major dose-limiting toxicity of interleukin-2 (IL-2) and of immunotoxin (IT) therapies is vascular leak syndrome (VLS). VLS is characterized by an increase in vascular permeability accompanied by extravasation of fluids and proteins resulting in interstitial edema and organ failure. Manifestations of VLS include fluid retention, increase in body weight, peripheral edema, pleural and pericardial effusions, ascites, anasarca and, in severe form, signs of pulmonary and cardiovascular failure. Symptoms are highly variable among patients and the causes are poorly understood. The pathogenesis of endothelial cell (EC) damage is complex and can involve activation or damage to ECs and leukocytes, release of cytokines and of inflammatory mediators, alteration in cell-cell and cell-matrix adhesion and in cytoskeleton function. VLS restricts the doses of IL-2 and of ITs which can be administered to humans and, in some cases, necessitates the cessation of therapy. This review discusses the diversity of clinical manifestation, possible mechanisms and therapeutic modalities for VLS induced by IL-2 and ITs.

Original languageEnglish (US)
Pages (from-to)117-132
Number of pages16
JournalImmunopharmacology
Volume37
Issue number2-3
DOIs
StatePublished - Oct 1997

Fingerprint

Immunotherapy
Blood Vessels
Interleukin-2
Edema
Cell-Matrix Junctions
Immunotoxins
Pericardial Effusion
Capillary Permeability
Pleural Effusion
Cytoskeleton
Ascites
Leukocytes
Therapeutics
Endothelial Cells
Body Weight
Cytokines
Lung
Proteins

Keywords

  • Endothelial cells
  • IL-2
  • Immunotoxins
  • Vascular leak

ASJC Scopus subject areas

  • Pharmacology

Cite this

Vascular leak syndrome : A side effect of immunotherapy. / Baluna, Roxana; Vitetta, Ellen S.

In: Immunopharmacology, Vol. 37, No. 2-3, 10.1997, p. 117-132.

Research output: Contribution to journalArticle

Baluna, Roxana ; Vitetta, Ellen S. / Vascular leak syndrome : A side effect of immunotherapy. In: Immunopharmacology. 1997 ; Vol. 37, No. 2-3. pp. 117-132.
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