Aldesleukin (IL-2, Proleukin or interleukin 2)
This page tells you about the biological therapy drug aldesleukin (interleukin 2) and its possible side effects. There is information about
- What aldesleukin (interleukin 2) is
- How aldesleukin works
- How you have aldesleukin
- Tests during treatment
- About side effects
- Common side effects
Aldesleukin is a man made protein. It is very similar to a protein produced by the body called interleukin-2 (IL-2). Interleukin-2 is part of the immune system. It activates certain white blood cells in the body called lymphocytes, which fight diseases and infections.
Aldesleukin works in a number of ways. It
- works directly on cancer cells by interfering with how the cells grow and multiply
- stimulates the immune system by encouraging the growth of killer T cells and other cells that attack cancer cells
- encourages cancer cells to send out chemicals that attract immune system cells
Aldesleukin is most often given as an injection just under the skin but it can also be given into a vein.
Injection just under the skin
You usually have a daily injection for 5 days then 2 days rest. You have it like this for 4 weeks and then have a week without treatment. Then this 5 week cycle is repeated. The number of cycles of treatment you need depends on how well your cancer responds to it.
Your nurse can teach you to give the injection yourself at home or a family member can learn how to do it. You can also look at our video about giving an injection under the skin. You need to keep your aldesleukin in the fridge.
Aldesleukin into the bloodstream
You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.
If you have aldesleukin into a vein over several days or in high doses, you will need to stay in hospital for your treatment. Then the medical staff can keep a close eye on how you are coping with it.
You can read our information about having cancer drugs.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We've listed the side effects associated with aldesleukin. You can use the links to find out more about each side effect. Where there is no link, please go to our information about cancer drug side effects or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having aldesleukin with other medicines.
Tell your doctor, nurse or pharmacist straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of the side effects listed below.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
- Tiredness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Flu like symptoms – fever, chills, headaches, and aching muscles and joints affect nearly everyone at first. They usually get better as the course of treatment continues. Symptoms usually begin 2 to 4 hours after your injection and last for about 12 hours. Try having your injection with paracetamol before bed to see if that helps
- Confusion, depression and extreme sleepiness – this is more common in older patients or people who have had depression before. Tell your doctor or nurse straight away if you have these effects
- Fluid may leak out of the small blood vessels in your body (vascular leak syndrome) if you have aldesleukin through a drip – you may have steroids to try and prevent this, but it can cause low blood pressure, low urine output, difficulty breathing, weight gain and swelling in your ankles, legs and face (oedema). If you have any of these signs tell your doctor or nurse
- Inflammation of the lung tissue that may cause breathlessness or a cough – tell your doctor or nurse straight away if you have this
- A skin rash – you may have red, dry and itchy skin, peeling, or small blisters and your doctor or nurse may give you medicines or creams
- Feeling or being sick – tell your doctor or nurse if you have this, as there are many different medicines that can help
- Diarrhoea – drink plenty of fluids and tell your doctor or nurse if diarrhoea becomes severe or continues for more than 3 days
- Loss of appetite
- Difficulty sleeping
- Feeling anxious or confused
- A sore mouth
- Redness, swelling and soreness at the injection site if you have injections under the skin – you can reduce this by giving the injection in a different place each time
Between 1 and 10 in every 100 people have one or more of these.
- Heart problems – sometimes aldesleukin can affect the way your heart works, causing low blood pressure, dizziness, chest pain or palpitations. These nearly always get better when treatment stops. Tell your doctor if you have had heart problems before or if you have any of these side effects
- Kidney changes that are mild and unlikely to cause symptoms may occur – they will almost certainly go back to normal when treatment is finished
- A sore mouth
- Low levels of thyroid hormones (hypothyroidism) – you may feel tired or cold, or your voice may deepen
- Bleeding into the digestive system (stomach, bowel or back passage), that can cause black bowel motions, vomiting blood, a swollen tummy (abdomen), and difficulty swallowing
- Sudden fainting or unconsciousness and loss of ability to speak caused by nerve changes
- Blood clots – let your nurse or doctor know if you have a sore, painful, red area on your leg or sudden chest pain and breathlessness
- A high blood calcium level (hypercalcaemia) with symptoms such as feeling sick (nausea), vomiting or constipation
- High levels of lactic acid in the blood, causing difficulty breathing, tiredness, being sick and drowsiness
- A low level of calcium in the blood (hypocalcaemia) with possible muscle weakness, and twitching or tingling fingers
- A high level of potassium (hyperkalaemia) causing muscle cramps, an abnormal heart beat, dizziness and headaches
- Inflammation of the whole body, causing a high temperature and high white blood cell levels, or a low white blood cell level, low temperature and being sick. Tell your doctor or nurse straight away if you have any of these
- A blocked up nose
- Low or high blood pressure – let your nurse or doctor know if you have dizziness, blurred vision or a constant headache
- Mood changes, such as irritability, excitement, restlessness (agitation) and depression
- Seeing things that are not there (hallucinations)
- Loss of control of movements
- Itching and tingling of fingers or toes
- Taste changes
- Indigestion after meals
- Swollen lips
- Hair loss
- Constipation – drink plenty of fluids if you have constipation. Tell your doctor or nurse if it lasts for more than 3 days as they can give you laxatives
- Sore eyes with itching, redness and swelling
- High blood sugar levels (hyperglycaemia) causing thirst, hunger, tiredness and passing a lot of urine
- Higher levels of thyroid hormones (hyperthyroidism). You may lose weight or feel hot, anxious, or hyperactive
- An allergic reaction – tell your nurse or doctor straight away if you have a sudden skin rash, itching, breathlessness or swelling of the lips, face or throat
- A dry mouth a thirst due to dehydration – let your doctor or nurse know if you have this
- Muscle or joint pain
- Eye inflammation – your nurse can give you eye drops to help
- Inflammation around the drip site caused by drugs leaking into the tissues – tell your nurse or doctor if you have any stinging or burning, leakage of fluid, or redness or swelling around your drip site during or after treatment
Fewer than 1 in 100 people have these effects.
- Muscle weakness (myasthenia)
- Lack of colour in the skin (vitiligo)
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Tell your doctor if you have shingles or exposure to someone with chickenpox. Aldesleukin treatment may make shingles flare up. Let your doctor know if you have heart disease because aldesleukin can affect your heart.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don't breastfeed during this treatment because the drug may come through in the breast milk.
You shouldn't have immunisations with live vaccines while you are having this treatment and for 3 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your treatment. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
This page doesn't list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at
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