- Adjuntive immunotherapy of various tumors (including neuroblastoma)
THIS MEDICATION IS TO BE ADMINISTERED BY A CHEMO-TRAINED NURSE. IF THE NURSE IS NOT CHEMO-TRAINED, THEY ARE TO CONTACT THE UNIT NURSE EDUCATOR OR ADVANCED PRACTICE NURSE.
- In line filters should not be used
- Available in vials of 22 MU of lyophilized powder queal to 1.3 mg of protein. Reconstitute vial with 1.2 mL of sterile water to yield an 18 MU/mL concentration. DO NOT USE preserved water; it will result in precipitate formation.
- Direct diluent against the side of the vial to prevent foaming. Gently swirl to dissolve contents. DO NOT SHAKE vial.
- Protect from light
- Reconstituted vials are stable 48 hours in the fridge
- Dilute further with D5W. DO NOT USE saline-containing solution or solutions containing preservatives. See chart below for stability
|Final Dilution Concentration
|Stability in D5W|
|0.016 - 1.12 MU/mL||Albumin must be added to cassette prior to addition of aldesleukin at a final concentration of 0.1% (1 mg/mL) albumin, stable at room temperature for 6 days|
|1.13- 1.6 MU/mL||Unstable; avoid use|
|1.61 - 9 MU/mL||Stable at room temperature for 6 days (no albumin necessary)|
- Solutions Compatible: D5W ONLY
- Y-site Compatible: morphine
- Incompatible: saline-containing solutions or solutions containing preservatives. Run in dedicated line
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
|IV Intermittent infusion||YES|
|IV Continuous infusion||YES, via CADD pump|
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
- Neuroblastoma Protocol COG ANBL0032
- 3 MU/m2/day for days 0-3
- 4.5 MU/m2/day for days 7-10
- For adults, the range varies depending on the tumor treated (i.e. approximately 2 MU/m2/day -50 MU/m2/day)
** Dosage range is highly variable. Dosage may differ according to protocol.
- Most Common Serious Reactions: (usually with higher doses) fever, chills, nausea, vomiting, hypotension (sometimes requires pressors), anemia, diarrhea, oliguria/anuria, mental status changes, tachycardia, increased liver function tests and thrombocytopenia.
- Occasional Serious Reactions: (usually with higher doses) vascular capillary leak sydrome, seizure, paresthesia, vision changes, bronchospasm, anaphylaxis, pulmonary edema, ARDS, desquamating rash, pruritis, hyperuricemia, hypoglycemia, hypocalcemia, acidosis, hyponatremia, coagulopathy
- Rare Serious Events: myocardial infarction, bowel perforation/infaction, gangrene and death have been reported
*Treatment from unusual side effects are available through the study chair identified on the front page of the protocol and/or pharmacy
- PATIENTS SHOULD HAVE NORMAL CARDIAC, PULMONARY, HEPATIC AND CNS FUNCTION AT THE START OF THERAPY
- Continued administration in patients who develop moderate to severe lethargy or somnolence may result in coma
- DO NOT administer dexamethasone for any reason other than the management of life-threatening toxicity. Dexamethasone (and other steroids) interfere with the anti-tumor action of aldesleukin. Do not use steroid as an antiemetic.