Parenteral Manual

Aldesleukin (NON-FORMULARY)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
INTERLEUKIN 2, PROLEUKIN®
Classification: 
Biologic Response Modifier, Antineoplastic - NON-CYTOTOXIC HAZARDOUS
Original Date: 
August 2005
Revised Date: 
June 2015
Indications: 
  • 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.

Reconstitution and Stability: 
  • 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
(MU/mL)
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)
Compatibility: 

- Solutions Compatible: D5W ONLY

- Y-site Compatible: morphine

- Incompatible: saline-containing solutions or solutions containing preservatives.  Run in dedicated line

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Push NO
IV Intermittent infusion YES
IV Continuous infusion YES, via CADD pump
Dosage: 

(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.

Potential hazards of parenteral administration: 
  • 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

Notes: 
  •  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.

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