A phase I trial of recombinant human interleukin-6 in patients with myelodysplastic syndromes and thrombocytopenia

Michael S. Gordon, John Nemunaitis, Ron Hoffman, Ronald L. Paquette, Craig Rosenfeld, Sheryl Manfreda, Randi Isaacs, Stephen D Nimer

Research output: Contribution to journalArticle

106 Citations (Scopus)

Abstract

To evaluate the hematologic effects of recombinant human interleukin-6 (rhIL-6, Escherichia coli, SDZ ILS 969, IL-6), and determine its toxicity profile, we performed a phase I trial of IL-6 in 22 patients with various myelodysplastic syndromes (MDS), platelet counts <100,000/μL, and <5% bone marrow (BM) blasts. Patients received one of four doses of IL-6 (1.0, 2.5, 3.75, and 5.0 μg/kg/d) as a subcutaneous injection on day 1, followed by a 7-day wash-out period, and then 28 days of IL-6 therapy. Dose-limiting toxicities of fatigue, fever, and elevated alkaline phosphatase were seen at 5.0 μg/kg/d; the maximum tolerated dose was 3.75 μg/kg/d. All patients experienced at least grade II fever and all had an increase in acute phase proteins. Eight patients (36%) experienced at least a transient improvement in platelet counts; three fulfilled the criteria for response, whereas five others had clinically significant increases that failed to meet response criteria. Various IL-6-related toxicities prevented more than three patients from receiving maintenance therapy. Two of the three patients who received maintenance IL-6 therapy had a persistent increase in platelet counts, during 3 and 12 months of IL-6 therapy, respectively. Laboratory studies indicated that IL-6 increased the frequency of higher ploidy megakaryocytes but did not significantly increase the number of assayable megakaryocytic progenitor cells, suggesting that IL-6 acts as a maturational agent rather than a megakaryocyte colony-stimulating factor. Although IL-6 therapy can promote thrombopoiesis in some MDS patients, its limited activity and significant therapy-related toxicity preclude its use as a single agent in this patient population. Further studies, combining low doses of IL-6 with other hematopoietic growth factors, are underway.

Original languageEnglish
Pages (from-to)3066-3076
Number of pages11
JournalBlood
Volume85
Issue number11
StatePublished - Jun 1 1995
Externally publishedYes

Fingerprint

Myelodysplastic Syndromes
Thrombocytopenia
Interleukin-6
Toxicity
Platelets
Platelet Count
Fever
Therapeutics
Thrombopoiesis
Thrombopoietin
Megakaryocytes
Maximum Tolerated Dose
Acute-Phase Proteins
Ploidies
Proxy
Subcutaneous Injections
Escherichia coli
Fatigue
Alkaline Phosphatase
Intercellular Signaling Peptides and Proteins

ASJC Scopus subject areas

  • Hematology

Cite this

Gordon, M. S., Nemunaitis, J., Hoffman, R., Paquette, R. L., Rosenfeld, C., Manfreda, S., ... Nimer, S. D. (1995). A phase I trial of recombinant human interleukin-6 in patients with myelodysplastic syndromes and thrombocytopenia. Blood, 85(11), 3066-3076.

A phase I trial of recombinant human interleukin-6 in patients with myelodysplastic syndromes and thrombocytopenia. / Gordon, Michael S.; Nemunaitis, John; Hoffman, Ron; Paquette, Ronald L.; Rosenfeld, Craig; Manfreda, Sheryl; Isaacs, Randi; Nimer, Stephen D.

In: Blood, Vol. 85, No. 11, 01.06.1995, p. 3066-3076.

Research output: Contribution to journalArticle

Gordon, MS, Nemunaitis, J, Hoffman, R, Paquette, RL, Rosenfeld, C, Manfreda, S, Isaacs, R & Nimer, SD 1995, 'A phase I trial of recombinant human interleukin-6 in patients with myelodysplastic syndromes and thrombocytopenia', Blood, vol. 85, no. 11, pp. 3066-3076.
Gordon MS, Nemunaitis J, Hoffman R, Paquette RL, Rosenfeld C, Manfreda S et al. A phase I trial of recombinant human interleukin-6 in patients with myelodysplastic syndromes and thrombocytopenia. Blood. 1995 Jun 1;85(11):3066-3076.
Gordon, Michael S. ; Nemunaitis, John ; Hoffman, Ron ; Paquette, Ronald L. ; Rosenfeld, Craig ; Manfreda, Sheryl ; Isaacs, Randi ; Nimer, Stephen D. / A phase I trial of recombinant human interleukin-6 in patients with myelodysplastic syndromes and thrombocytopenia. In: Blood. 1995 ; Vol. 85, No. 11. pp. 3066-3076.
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