Immune System Stimulants -Fitz Flashcards
Cytokines:
- INF alpha
- IL-2
TNF alpha
What are the common characteristics?
- short half lives
- recruit immune cells to do actual cell kill
- Have serious, sometimes fatal, side effects.
Interleukin 2:
MOA?
induces and expands a T cell response cytolytic for tumor cells
Use to make LAK or CIK cells
short half life
Interleukin 2:
Side effects-
- cytokine storm
- fever/chills, diarrhea, hand-foot syndrome (palmar-plantar erythrodysesthesia)
- fatal hypotension , thrombocytopenia, shock, respiratory distress, coma
Interferon alpha
3 mechanisms of anti-tumor activity:
- decreases production of fibroblast growth factor (FGF)
- Inhibition of cell division (normal and cancer cells)
- Increase class MHC I expression on tumor cells back to normal (stupid cancer cells down regulate MHC I sometimes)
Interferon alpha side effects:
-depresion
- flu-like symptoms
- hypotension
- myelosuppresion (not as bad as cytotoxic drugs)
Tumor Necrosis Factor alpha
effects?
-causes:
fibroblast proliferatinon
chemokine induction (IL-6, IL-8)
T and B cell activation
Drug with shortest half life?
TNF- alpha
Hey, let’s give this as intra arterial administration
(only lasts 1-2 minutes)
What are the severe dose limiting toxicity of TNF alpha?
Malaise and flu-like symptoms
-it can cause hemorrhagic necrosis
Hematopoietic agents:
What are they and what do they produce?
Erythropoietin—> RBCs
Filgrastim (G-CSF) —-> neutrophils
Interleukin 11 –>platelets
Thrombopoietin/Romiplostim –> platelets
Sargramostim (GM-CSF) —-> granulocytes, eosinophils, basophils, monocytes
Why do we give hematopoietic agents?
Well, as you should know:
BMS is dose-limiting complication of antineoplastics
These drugs activate specific progenitor cells which result in production of marrow products: RBC, WBC, platelets.
