Effects of total parenteral nutrition (TPN) during high-dose interleukin-2 treatment for metastatic cancer

Wolfram E. Samlowski, Gail Wiebke, Martha McMurry, Motomi (Tomi) Mori, John H. Ward

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Patients treated with high doses of interleukin-2 (IL-2) develop profound anorexia, malaise, loss of energy, mucositis, nausea, and vomiting, which may contribute to poor nutrition. We hypothesized that total parenteral nutrition (TPN) administration would ameliorate these changes and could improve fluid and electrolyte balance. A retrospective analysis of protein and energy intake was performed in 21 sequential patients who received a normal diet (controls) and 16 subsequent patients who received TPN during IL- 2 treatment. The effect of TPN on laboratory abnormalities induced by IL-2 was also evaluated. Within 24 h of starting IL-2, mean energy intake declined to 2.5-2.8 kcal/kg in controls in contrast to the energy intake of 25-29 kcal/kg in patients receiving TPN. Protein nutrition was affected in a similar fashion, with a markedly lower protein intake in controls (0.08-0.12 g/kg) than in the TPN group (1.02-1.10 g/kg). TPN improved serum calcium and potassium concentrations, particularly during spontaneous diuresis after completion of IL-2 treatment. Unexpectedly, TPN decreased the frequency and severity of cholestatic jaundice caused by IL-2. Patients receiving TPN had an increased propensity for hyperglycemia and hypophosphatemia. High-dose intravenous bolus IL-2 therapy resulted in a markedly negative nutritional balance in control patients. A brief period of TPN during IL-2 treatment was well tolerated and corrected calorie and protein malnutrition. TPN administration also improved control of serum electrolytes. TPN did not adversely affect tumor progression or patient survival.

Original languageEnglish (US)
Pages (from-to)65-74
Number of pages10
JournalJournal of Immunotherapy
Volume21
Issue number1
DOIs
StatePublished - 1998
Externally publishedYes

Fingerprint

Total Parenteral Nutrition
Interleukin-2
Neoplasms
Energy Intake
Therapeutics
Water-Electrolyte Balance
Hypophosphatemia
Protein-Energy Malnutrition
Mucositis
Proteins
Obstructive Jaundice
Diuresis
Anorexia
Serum
Hyperglycemia
Nausea
Electrolytes
Vomiting
Potassium
Diet

Keywords

  • Cancer immunotherapy
  • Interleukin-2
  • Malignant melanoma
  • Renal cell carcinoma
  • Total parenteral nutrition

ASJC Scopus subject areas

  • Cancer Research
  • Pharmacology
  • Immunology

Cite this

Effects of total parenteral nutrition (TPN) during high-dose interleukin-2 treatment for metastatic cancer. / Samlowski, Wolfram E.; Wiebke, Gail; McMurry, Martha; Mori, Motomi (Tomi); Ward, John H.

In: Journal of Immunotherapy, Vol. 21, No. 1, 1998, p. 65-74.

Research output: Contribution to journalArticle

Samlowski, Wolfram E. ; Wiebke, Gail ; McMurry, Martha ; Mori, Motomi (Tomi) ; Ward, John H. / Effects of total parenteral nutrition (TPN) during high-dose interleukin-2 treatment for metastatic cancer. In: Journal of Immunotherapy. 1998 ; Vol. 21, No. 1. pp. 65-74.
@article{b32164e392984df584730877fb0271e5,
title = "Effects of total parenteral nutrition (TPN) during high-dose interleukin-2 treatment for metastatic cancer",
abstract = "Patients treated with high doses of interleukin-2 (IL-2) develop profound anorexia, malaise, loss of energy, mucositis, nausea, and vomiting, which may contribute to poor nutrition. We hypothesized that total parenteral nutrition (TPN) administration would ameliorate these changes and could improve fluid and electrolyte balance. A retrospective analysis of protein and energy intake was performed in 21 sequential patients who received a normal diet (controls) and 16 subsequent patients who received TPN during IL- 2 treatment. The effect of TPN on laboratory abnormalities induced by IL-2 was also evaluated. Within 24 h of starting IL-2, mean energy intake declined to 2.5-2.8 kcal/kg in controls in contrast to the energy intake of 25-29 kcal/kg in patients receiving TPN. Protein nutrition was affected in a similar fashion, with a markedly lower protein intake in controls (0.08-0.12 g/kg) than in the TPN group (1.02-1.10 g/kg). TPN improved serum calcium and potassium concentrations, particularly during spontaneous diuresis after completion of IL-2 treatment. Unexpectedly, TPN decreased the frequency and severity of cholestatic jaundice caused by IL-2. Patients receiving TPN had an increased propensity for hyperglycemia and hypophosphatemia. High-dose intravenous bolus IL-2 therapy resulted in a markedly negative nutritional balance in control patients. A brief period of TPN during IL-2 treatment was well tolerated and corrected calorie and protein malnutrition. TPN administration also improved control of serum electrolytes. TPN did not adversely affect tumor progression or patient survival.",
keywords = "Cancer immunotherapy, Interleukin-2, Malignant melanoma, Renal cell carcinoma, Total parenteral nutrition",
author = "Samlowski, {Wolfram E.} and Gail Wiebke and Martha McMurry and Mori, {Motomi (Tomi)} and Ward, {John H.}",
year = "1998",
doi = "10.1097/00002371-199801000-00009",
language = "English (US)",
volume = "21",
pages = "65--74",
journal = "Journal of Immunotherapy",
issn = "1524-9557",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Effects of total parenteral nutrition (TPN) during high-dose interleukin-2 treatment for metastatic cancer

AU - Samlowski, Wolfram E.

AU - Wiebke, Gail

AU - McMurry, Martha

AU - Mori, Motomi (Tomi)

AU - Ward, John H.

PY - 1998

Y1 - 1998

N2 - Patients treated with high doses of interleukin-2 (IL-2) develop profound anorexia, malaise, loss of energy, mucositis, nausea, and vomiting, which may contribute to poor nutrition. We hypothesized that total parenteral nutrition (TPN) administration would ameliorate these changes and could improve fluid and electrolyte balance. A retrospective analysis of protein and energy intake was performed in 21 sequential patients who received a normal diet (controls) and 16 subsequent patients who received TPN during IL- 2 treatment. The effect of TPN on laboratory abnormalities induced by IL-2 was also evaluated. Within 24 h of starting IL-2, mean energy intake declined to 2.5-2.8 kcal/kg in controls in contrast to the energy intake of 25-29 kcal/kg in patients receiving TPN. Protein nutrition was affected in a similar fashion, with a markedly lower protein intake in controls (0.08-0.12 g/kg) than in the TPN group (1.02-1.10 g/kg). TPN improved serum calcium and potassium concentrations, particularly during spontaneous diuresis after completion of IL-2 treatment. Unexpectedly, TPN decreased the frequency and severity of cholestatic jaundice caused by IL-2. Patients receiving TPN had an increased propensity for hyperglycemia and hypophosphatemia. High-dose intravenous bolus IL-2 therapy resulted in a markedly negative nutritional balance in control patients. A brief period of TPN during IL-2 treatment was well tolerated and corrected calorie and protein malnutrition. TPN administration also improved control of serum electrolytes. TPN did not adversely affect tumor progression or patient survival.

AB - Patients treated with high doses of interleukin-2 (IL-2) develop profound anorexia, malaise, loss of energy, mucositis, nausea, and vomiting, which may contribute to poor nutrition. We hypothesized that total parenteral nutrition (TPN) administration would ameliorate these changes and could improve fluid and electrolyte balance. A retrospective analysis of protein and energy intake was performed in 21 sequential patients who received a normal diet (controls) and 16 subsequent patients who received TPN during IL- 2 treatment. The effect of TPN on laboratory abnormalities induced by IL-2 was also evaluated. Within 24 h of starting IL-2, mean energy intake declined to 2.5-2.8 kcal/kg in controls in contrast to the energy intake of 25-29 kcal/kg in patients receiving TPN. Protein nutrition was affected in a similar fashion, with a markedly lower protein intake in controls (0.08-0.12 g/kg) than in the TPN group (1.02-1.10 g/kg). TPN improved serum calcium and potassium concentrations, particularly during spontaneous diuresis after completion of IL-2 treatment. Unexpectedly, TPN decreased the frequency and severity of cholestatic jaundice caused by IL-2. Patients receiving TPN had an increased propensity for hyperglycemia and hypophosphatemia. High-dose intravenous bolus IL-2 therapy resulted in a markedly negative nutritional balance in control patients. A brief period of TPN during IL-2 treatment was well tolerated and corrected calorie and protein malnutrition. TPN administration also improved control of serum electrolytes. TPN did not adversely affect tumor progression or patient survival.

KW - Cancer immunotherapy

KW - Interleukin-2

KW - Malignant melanoma

KW - Renal cell carcinoma

KW - Total parenteral nutrition

UR - http://www.scopus.com/inward/record.url?scp=0031594528&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031594528&partnerID=8YFLogxK

U2 - 10.1097/00002371-199801000-00009

DO - 10.1097/00002371-199801000-00009

M3 - Article

C2 - 9456439

AN - SCOPUS:0031594528

VL - 21

SP - 65

EP - 74

JO - Journal of Immunotherapy

JF - Journal of Immunotherapy

SN - 1524-9557

IS - 1

ER -