Edema oprelvekin

Recombinant human IL-11 (oprelvekin) is a polypeptide of 177 amino acids. It differs from natural IL-11 due to lack of glycosylation and the amino-terminal proline residue. Oprelvekin is administered by subcutaneous injection, usually 6-24 h after chemotherapy, at a dose of 25-50 p,g/kg per day. The drug has a half-life of about 7h. It is used to stimulate bone marrow to induce platelet production in nonmyeloid malignancies in patients undergoing chemotherapy. The common side effects of oprelvekin include fluid retention, tachycardia, edema, nausea, vomiting, diarrhea, shortness of breath and mouth sores. Other side effects include rash at the injection site, blurred vision, paresthesias, headache, fever, cough and bone pain. Rarely, CLS may occur. 

Oprelvekin has thrombopoietic activity and has been licensed to prevent severe thrombocytopenia and reduce the need for platelet transfusion after myelosuppressive chemotherapy (1). Common adverse effects included myalgia and arthralgias, fatigue, headache, and conjunctival injection. Peripheral edema, dyspnea, pleural effusions, tachycardia, and anemia were supposedly the result of oprelvekin-induced fluid retention (SEDA-20, 336) (SEDA-21, 376). Atrial flutter or fibrillation were sometimes noted. 

A preliminary study of the thrombopoietic effect of oprelvekin (50 pg/kg/day for 21 days) in patients with refractory immune thrombocjrtopenic purpura was halted, since all of the first seven patients had adverse effects without significant changes in the platelet count (3). Adverse effects consisted of conjunctival injection, diffuse aches and joint pains, marked pedal edema, pete-chiae, and mild anemia. In addition, one patient had a neuropathy, which resolved more than 1 month after oprelvekin withdrawal. 

Oprelvekin causes many adverse reactions. Among these are edema, neutropenic fever, headache, nausea and/or vomiting. dyspnea, and tachycardia. Patients must be monitored closely. 

The drug is administered at 25-50 /tg/kg/day subcutaneously. Oprelvekin is approved for use in patients undergoing chemotherapy for nonmyeloid malignancies who display severe thrombocytopenia (platelet count <20,000//iL) on a prior cycle of the same chemotherapy and is administered until the platelet count is >100,000//tL. The major complications of therapy are fluid retention and associated cardiac symptoms, such as tachycardia, palpitation, edema, and shortness of breath this is a significant concern in elderly patients and often requires concomitant therapy with diuretics. Fluid retention reverses upon drug discontinuation, but volume status should be carefully monitored in elderly patients, those with a history of heart failure, or those with preexisting pleural or pericardial effusions or ascites. Also reported are blurred vision, injection-site rash or erythema, and paresthesias. 

Oprelvekin rhIL-11 ThrtHnbocytoptmia in chemotherapy Hypersensitivity, fluid retention, pulmonary edema, ventricular arrhythmias... 

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