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Denileukin review
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Denileukin diftitox is a protein engineered to combine both Interleukin-2 and Diphtheria toxin to form an antineoplastic agent. It inhibits cellular growth by binding to Interleukin-2 receptors, and killing them as a result. This is useful in the treatment of certain cancers such as leukemia and lymphoma as their cancer cells can be targeted by denileukin difitox because they express Interleukin-2 receptors. It is popularly known under the brand name Ontak in an injection preparation.
It also sees application for treating malignant melanoma, the most widespread cause of death in skin cancer cases. Even at stage IV of the cancer, malignant melanoma tumors have been observed to regress and some even stabilize when administered this drug. This has extended life expectancy from 8 months to a year in cases – a huge step considering the poor response this cancer has on most treatments.
Denileukin diftitox is usually prescribed to patients suffering from cutaneous T-cell lymphoma, a cancer which affects a certain type of white blood cell and cause lesions to appear on the patient’s skin. It has also recently been observed to be beneficial in treating malignant melanoma, as it can potentially extend life expectancy of even the worst cases.
Denileukin diftitox is usually administered by your healthcare professional in the hospital. Before administering denileukin diftitox, take an antihistamine and acetaminophen before receiving the infusion. Dosage will vary in each case depending on age, body size and medical history. The recommended dose is 9 to 18 mcg/kg/day of Denileukin diftitox via IV infusion over a period of 30 minutes to an hour. This dose is to be taking every day for 5 consecutive days. This is repeated after every 21 days for about 8 cycles.
The vials of denileukin diftitox are kept frozen and should be thawed first in the refrigerator at 2 to 8°C (36 to 46°F) but not longer than 24 hours. It can also be thawed at room temperature for 1 to 2 hours.
When finally thawed and brought to room temperature, mix the solution slowly but do not shake the vial. Inspect the solution if any discoloration or particles are seen. Do not use if either is observed. Do not refreeze thawed vials and do not reuse any leftover portions.
Make sure denileukin diftitox concentration is at 15 mcg/ml or higher, and do not use glass containers when preparing or holding the solution. Use soft plastic IV bags or plastic syringes. When it is ready to be administered, withdraw the calculated amount for the dose from the vial and inject it into an empty IV bag. Then add sterile saline solution into the bag, but not more than 9 mL of saline for every 1 mL of denileukin diftitox.
Do not take this prepared solution along with other drugs and administer the preparation using an IV infusion bag or syringe pump within 6 hours.
Common side effects include body pains, particularly in the back or chest. Some may experience dizziness or near fainting, irregular heartbeat, difficulty breathing, fevers and chills, swelling of the face and lower extremities or difficulty in swallowing.
Other more serious side effects include severe abdominal pain, changes in stool and urine quality including the presence of blood, dark or cloudy urine and tarry, black stools. Some may experience confusion resulting in slurred speech and vision changes, unusual tendency to bleed and bruise, and swelling of the injection site. Consult with your doctors immediately if you experience these side effects.
Doctors may have to monitor for capillary leak syndrome which may occur anytime during the treatment and could cause death. Edema, weight, serum albumin and blood pressure all need to be regularly monitored while treatment to prevent this condition.
Loss of vision acuity has also been reported, including but not limited to loss of color vision. Though most do recover from this side effect, some report persistent damage to vision acuity.
• Molecular formula of denileukin diftitox is C2560H4042N678O799S17
• Chemical IUPAC Name is Diptheria toxin-Interleukin-2 fusion protein
• Molecular weight is 57647.3 g/mol
Review published on: 13 July 2009
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