Immunologic Therapies Health Article

Definition

Immunologic therapy is an approach to the treatment of disease that uses medicines for stimulating the body's natural immune response.

Purpose

Immunologic therapy is used to improve the immune system's natural ability to fight such diseases as cancer, hepatitis, and AIDS. These drugs may also be used to help the body recover from immunosuppression resulting from such treatments as chemotherapy or radiation therapy.

Description

Most drugs in this category are synthetic versions of substances produced naturally in the body. In their natural forms, these substances help defend the body against disease. For example, aldesleukin (Proleukin) is an artificial form of interleukin-2, which helps white blood cells work. Aldesleukin is administered to patients with kidney cancers and skin cancers that have spread to other parts of the body. Filgrastim (Neupogen) and sargramostim (Leukine) are versions of natural substances called colony stimulating factors, which encourage the bone marrow to make new white blood cells. Another type of drug, epoetin (Epogen, Procrit), is a synthetic version of human erythropoietin, which stimulates the bone marrow to make new red blood cells. Thrombopoietin stimulates the production of platelets, which are disk-shaped bodies in the blood that are important in clotting. Interferons are substances that the body produces naturally, using cells in the immune system to fight infections and tumors. Synthetic interferons carry such brand names as Alferon, Roferon or Intron A. Some of the interferons that are currently in use as medications are recombinant interferon alfa-2a, recombinant interferon alfa-2b, interferon alfa-n1, and interferon alfa-n3. Alfa interferons are used to treat hairy cell leukemia, malignant melanoma, and Kaposi's sarcoma, which is a type of cancer associated with HIV infection. In addition, interferons are also used to treat such other conditions as laryngeal papillomatosis, genital warts, and certain types of hepatitis.

Recommended dosage

The recommended dosage depends on the type of immunologic therapy. For some medicines, the physician will decide the dosage for each patient, taking into account a patient's weight and whether he or she is taking other medicines. Some drugs used in immunologic therapy are given only in a hospital under a physician's supervision. Patients who are taking drugs that can be used at home should consult the physician who prescribed the medicine or the pharmacist who filled the prescription for the correct dosage.

Most of these drugs come in an injectable form, which is generally administered by a cancer care provider.

Aldesleukin

Aldesleukin may cause serious side effects. It is ordinarily given only in a hospital, where medical professionals can watch for early signs of problems. Medical tests may be performed to check for unwanted side effects. In general, anyone who has breathing problems, fever or chills while being given aldesleukin should consult their doctor at once.

Other side effects should be brought to a physician's attention as soon as possible:

• dizziness
• drowsiness
• confusion
• agitation

• depression
• nausea and vomiting
• diarrhea
• sores in the mouth and on the lips
• tingling of hands or feet
• decrease in urination
• unexplained weight gain of five or more pounds (2 or more kilograms)

Some side effects of aldesleukin are usually temporary and do not need medical attention unless they are bothersome. These include dry skin, itchy or burning rash or redness followed by peeling, loss of appetite, and a general feeling of illness or discomfort.

Colony stimulating factors

Patients sometimes experience mild pain in the lower back or hips in the first few days of treatment with colony stimulating factors. This side effect is not a cause for concern, and usually goes away within a few days. If the pain is intense or causes discomfort, the physician may prescribe a painkiller.

Other possible side effects include headache, joint or muscle pain, and skin rash or itching. These side effects tend to disappear as the body adjusts to the medicine, and do not need medical treatment. If they continue, or if they interfere with normal activities, the patient should consult their physician.

Epoetin

Epoetin may cause such flu-like symptoms as muscle aches, bone pain, fever, chills, shivering, and sweating within a few hours after it is taken. These symptoms usually go away within 12 hours. If they persist or are severe, the patient should call their doctor. Other possible side effects of epoetin that do not need medical attention are diarrhea, nausea or vomiting, and fatigue or weakness.

Other side effects, however, should be brought to a physician's attention as soon as possible. These include headache; vision problems; a rise in blood pressure; fast heartbeat; weight gain; or swelling of the face, fingers, lower legs, ankles, or feet. Anyone who has chest pain or seizures after taking epoetin should seek professional emergency medical attention immediately.