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Shah NR, Declouette B, Ansari-Gilani K, Alhomoud MS, Hoimes C, Ramaiya NH, Güler E. High-dose interleukin-2 therapy related adverse events and implications on imaging. Diagn Interv Radiol 2021; 27:684-689. [PMID: 34559052 PMCID: PMC8480956 DOI: 10.5152/dir.2021.20503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/18/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022]
Abstract
High-dose interleukin-2 (HDIL-2) therapy was initially approved by the U.S. Food and Drug Administration for metastatic renal cell carcinoma (mRCC) and metastatic melanoma. IL-2 is able to promote CD8+ T cell and natural killer (NK) cell cytotoxicity to increase tumoricidal activity of the innate immune system. HDIL-2 therapy is associated with a wide spectrum of immune-related adverse events (irAEs) that can be radiologically identified. HDIL-2 toxicity can manifest in multiple organ systems, most significantly leading to cardiovascular, abdominal, endocrine, and neurological adverse events. The collective impact of the irAEs and the rise of immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors led to the demise of HDIL-2 as a primary therapy for mRCC and metastatic melanoma. However, with innovation in ICIs and the creation of mutant IL-2 conjugates, there has been a drive for combination therapy. Knowledge of the HDIL-2 therapy and HDIL-2 related adverse events with radiology relevance is critical in diagnostic image interpretation.
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Affiliation(s)
- Neal R. Shah
- From the Departments of Radiology (N.R.S., B.D., K.A.G., N.H.R., E.G.) and Hematology and Oncology (M.S.A., C.H.), University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Department of Medical Oncology (C.H.), Duke University School of Medicine, Durham, North Carolina, USA; Department of Radiology (E.G. ), Ege University Faculty of Medicine, Izmir, Turkey
| | - Brandon Declouette
- From the Departments of Radiology (N.R.S., B.D., K.A.G., N.H.R., E.G.) and Hematology and Oncology (M.S.A., C.H.), University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Department of Medical Oncology (C.H.), Duke University School of Medicine, Durham, North Carolina, USA; Department of Radiology (E.G. ), Ege University Faculty of Medicine, Izmir, Turkey
| | - Kianoush Ansari-Gilani
- From the Departments of Radiology (N.R.S., B.D., K.A.G., N.H.R., E.G.) and Hematology and Oncology (M.S.A., C.H.), University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Department of Medical Oncology (C.H.), Duke University School of Medicine, Durham, North Carolina, USA; Department of Radiology (E.G. ), Ege University Faculty of Medicine, Izmir, Turkey
| | - Mohammad S. Alhomoud
- From the Departments of Radiology (N.R.S., B.D., K.A.G., N.H.R., E.G.) and Hematology and Oncology (M.S.A., C.H.), University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Department of Medical Oncology (C.H.), Duke University School of Medicine, Durham, North Carolina, USA; Department of Radiology (E.G. ), Ege University Faculty of Medicine, Izmir, Turkey
| | - Christopher Hoimes
- From the Departments of Radiology (N.R.S., B.D., K.A.G., N.H.R., E.G.) and Hematology and Oncology (M.S.A., C.H.), University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Department of Medical Oncology (C.H.), Duke University School of Medicine, Durham, North Carolina, USA; Department of Radiology (E.G. ), Ege University Faculty of Medicine, Izmir, Turkey
| | - Nikhil H. Ramaiya
- From the Departments of Radiology (N.R.S., B.D., K.A.G., N.H.R., E.G.) and Hematology and Oncology (M.S.A., C.H.), University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Department of Medical Oncology (C.H.), Duke University School of Medicine, Durham, North Carolina, USA; Department of Radiology (E.G. ), Ege University Faculty of Medicine, Izmir, Turkey
| | - Ezgi Güler
- From the Departments of Radiology (N.R.S., B.D., K.A.G., N.H.R., E.G.) and Hematology and Oncology (M.S.A., C.H.), University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Department of Medical Oncology (C.H.), Duke University School of Medicine, Durham, North Carolina, USA; Department of Radiology (E.G. ), Ege University Faculty of Medicine, Izmir, Turkey
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Sparago J, Rademacher N, Dehghanpir S, Post J, Liu CC, Johnston AN. Investigation of the association between gall bladder wall thickness and hypoalbuminaemia in dogs. J Small Anim Pract 2021; 62:973-978. [PMID: 34254309 DOI: 10.1111/jsap.13358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 04/03/2021] [Accepted: 04/29/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the correlation between gallbladder wall thickness and serum/plasma albumin concentrations in dogs. MATERIALS AND METHODS Retrospective searches of digital medical record databases were conducted to identify dogs that had either severely low serum/plasma albumin concentration (<1.5 g/dL) or ultrasonographic evidence of gallbladder wall thickening (>2 mm). Analysis of covariance models were used to analyze gallbladder wall thickness with sample type (serum vs plasma), age, etiology, albumin, and albumin ' etiology as the covariates. RESULTS A total of 216 dogs met inclusion criteria. One-hundred and forty-six dogs had a thickened gallbladder wall (Group 1). Median serum/plasma albumin concentration for dogs in this group was 2.2 g/dL (1 to 5 g/dL), and 84 dogs (57.5%) had hypoalbuminemia (<2.5 g/dL). The search for dogs with severe hypoalbuminemia (< 1.5 g/dL) identified 70 dogs (Group 2). In this group, median gallbladder wall thickness was 1.3 mm (0.2 to 6.1 mm) and 17 dogs (24.3%) had a thickened gallbladder wall. Serum/plasma albumin concentration and gallbladder wall thickness were not significantly correlated for Group 1 (r = 0.0044, p = 0.9580) or Group 2 (r = -0.1137, p = 0.3487). A moderate negative correlation (-0.64) was identified between gallbladder wall thickness and albumin concentration in dogs with immune-mediated diseases (p = 0.03). CLINICAL SIGNIFICANCE Gallbladder wall thickness and serum/plasma albumin concentration are independent variables in dogs.
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Affiliation(s)
- J Sparago
- Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - N Rademacher
- Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - S Dehghanpir
- Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - J Post
- Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - C C Liu
- Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA, 70803, USA
| | - A N Johnston
- Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, 1909 Skip Bertman Drive, Baton Rouge, LA, 70803, USA
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