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Anthony A. Gaspari, MD; Michael T. Lotze, MD; Steven A. Rosenberg, MD, PhD; Jere B. Stern, MD; Stephen I. Katz, MD, PhD

JAMA. 1987;258(12):1624-1629.

Abstract
We have prospectively evaluated the skin changes that occurred in ten patients who were undergoing immunotherapy with interleukin 2 (IL-2) and autologous lymphokine-activated killer cells to treat cancer. Serial skin biopsy specimens were obtained before therapy (baseline), during IL-2 administration, and during IL-2/lymphokine-activated killer cell infusion. All patients developed an eruption that was characterized by macular erythema, with burning and pruritus of the skin. It began after two or three days of IL-2 infusion and was usually localized to the head and neck; it occasionally became generalized (ie, erythroderma). The eruption resolved with desquamation within 48 to 72 hours after cessation of infusion of IL-2. Histologically, the changes were not specific. The only consistent immunohistological finding noted was the presence of DR + /Leu-4 + lymphoid cells surrounding blood vessels in the papillary dermis, with fewer of these cells in the epidermis. There was no difference between the clinical or histological features of the eruption that occurred with IL-2 alone and that which occurred with IL-2 and lymphokine-activated killer cell infusion, suggesting that the cutaneous effects were mediated by IL-2 alone.

(JAMA 1987;258:1624-1629)

Author Affiliations
From the Dermatology (Drs Gaspari and Katz) and Surgery (Drs Lotze and Rosenberg) Branches and the Laboratory of Pathology (Dr Stern), National Cancer Institute, National Institutes of Health, Bethesda, Md.

Footnotes
Reprint requests to Bldg 10, Room 12N238, National Cancer Institute, Bethesda, MD 20892 (Dr Gaspari).

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