Antiphospholipid syndrome associated with immunotherapy for patients with melanoma

Cancer. 1994 Mar 15;73(6):1621-4. doi: 10.1002/1097-0142(19940315)73:6<1621::aid-cncr2820730613>3.0.co;2-e.

Abstract

Background: Immunotherapy for patients with cancer is associated with severe side effects, including the possible induction of autoantibodies. The latter was proven for antithyroid microsomal and antithyroglobulin antibodies.

Methods: This study was designed to evaluate antiphospholipid antibodies (APA) in 30 patients receiving three different forms of immunotherapy for disseminated melanoma using interleukin-2 (IL-2), alpha-interferon (alpha-interferon) or the combination of both.

Results: APA were detected in none of 18 patients treated with IL-2 alone, 2 of 4 (50%) treated with alpha-interferon alone, and 3 of 8 (37.5%) treated with the combination of both. In the last group, increased concentrations of APA were observed, while the patients were still receiving alpha-interferon alone. APA levels were not detected in any of 10 patients with melanoma who were not treated with alpha-interferon or IL-2. In patients with increased APA, five of five (100%) had a prolongation of the partial thromboplastin time and 4 or five (80%) had deep venous thrombosis, which in one patient was followed by pulmonary embolism.

Conclusions: The high incidence of therapy-induced elevated APA concentrations suggests that these should be carefully monitored in all patients receiving immunotherapy with alpha-interferon.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Antinuclear / analysis
  • Antibodies, Antinuclear / blood
  • Antibodies, Antiphospholipid / analysis*
  • Antibodies, Antiphospholipid / blood
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Antiphospholipid Syndrome / etiology*
  • Autoantibodies / analysis
  • Autoantibodies / blood
  • Cardiolipins / immunology
  • Carmustine / administration & dosage
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage
  • Dacarbazine / administration & dosage
  • Female
  • Humans
  • Immunoglobulin G / analysis
  • Immunotherapy / adverse effects
  • Interferon alpha-2
  • Interferon-alpha / administration & dosage
  • Interferon-alpha / adverse effects*
  • Interleukin-2 / administration & dosage
  • Interleukin-2 / adverse effects*
  • Male
  • Melanoma / drug therapy
  • Melanoma / therapy*
  • Middle Aged
  • Recombinant Proteins
  • Tamoxifen / administration & dosage
  • Thromboembolism / etiology

Substances

  • Antibodies, Antinuclear
  • Antibodies, Antiphospholipid
  • Autoantibodies
  • Cardiolipins
  • Immunoglobulin G
  • Interferon alpha-2
  • Interferon-alpha
  • Interleukin-2
  • Recombinant Proteins
  • Tamoxifen
  • Dacarbazine
  • Cisplatin
  • Carmustine