[Anatomopathological findings correlated with high-dose recombinant interleukin-2. Review of the literature and description of 2 autopsy cases].

After review of the pertinent literature on pathologic findings associated with Interleukin-2 (IL-2) therapy for metastatic malignancies (melanomas, renal cell carcinomas), two autoptic cases are described with particular emphasis on the cardiovascular and pulmonary changes. The authors report on the occurrence of massive transmural acute myocardial infarct in a patient with metastatic cutaneous melanoma, treated with recombinant IL-2, who did not show atherosclerotic lesions of the coronary arteries. Conversely, myocardial lesions were not found in the other patient with metastatic renal cell carcinoma, treated with recombinant IL-2; he had severe generalized atherosclerosis and died of pulmonary causes. It is suggested that myocardial direct toxic effects of IL-2 associated with capillary leak syndrome may determine a myocardial infarct. It is concluded that IL-2 therapy is not contra-indicated in oncologic patients with atherosclerosis of the coronaries if they are carefully monitored.