Table 1 Pre screening recommendations for high dose IL-2 therapy
From: High dose interleukin-2 (Aldesleukin) - expert consensus on best management practices-2014
| Â | Package insert guidelines | Current best practices |
|---|---|---|
Disease | MM or mRCC | MM: cutaneous better than mucosal/ocular mRCC: clear cell/mixed histology |
PS | 0-1 | 0-1 |
Cardiac function | All patients | Under 40-50 without history |
Thallium stress test-normal | Selective testing only | |
Over 40-50 or prior history | ||
EKG stress test-normal (off beta blockers) | ||
CAD corrected > 6-12 months | ||
EKG stress test, EF, motility-normal | ||
Cardiology consult | ||
Prior TKI | ||
3 month gap if possible | ||
EKG stress test, EF, motility-normal | ||
Abnormal stress test | ||
Cardiology consultation | ||
Pulmonary function | All patients | Under 40-50 without history |
PFTs with ABGs | Selective testing only | |
Over 40-50 or with history of smoking or pulmonary disease | ||
FEV1 ≥ 75% predicted | ||
Brain metastasis | No untreated CNS metastasis | Negative MRI |
Positive MRI | ||
Treated, asymptomatic, off steroids | ||
Infection | No active infections | No active infections |
Renal function | All patients | Serum creatinine ≤ 1.5 mg/dL |
Serum creatinine ≤ 1.5 mg/dL | Serum creatinine 1.5-2.0 mg/dL | |
Creatinine clearance > 60 ml/min | ||
Laboratory | All patients | Bilirubin ≤ 2.0 mg/dL |
Values within normal limits | Platelet count > 100,000 | |
Hemoglobin ≥ 9.0 g/100 ml | ||
ANC ≥ 1500/mm3 | ||
SGOT < 3x ULN | ||
Thyroid function normal | ||
Other | No steroids, autoimmune disease, allografts | |