Aldesleukin or IL-2 (Proleukin or interleukin 2)

Aldesleukin is also called interleukin 2. It is a type of biological therapy drug. Biological therapies are treatments that use natural body substances, or drugs that block them, to treat cancer. Interleukin 2 is a protein made naturally in the body as part of the immune response. So it is also called an immunotherapy. Now it can be made in the laboratory in large quantities to treat cancer and other illnesses.

Aldesleukin  is used to treat kidney cancer. It is also in clinical trials for some other types of cancer. It works in a number of ways. It works directly on cancer cells by interfering with how the cells grow and multiply. It stimulates the immune system by encouraging the growth of killer T cells and other cells that attack cancer cells. It also encourages cancer cells to send out chemicals that attract immune system cells.

Aldesleukin comes as a powder that is dissolved in sterile water to give a clear solution. You are most likely to have it as an injection just under the skin (subcutaneously). But you may have it into a vein through a small tube (cannula), either as an injection or through a drip. How often you have it depends on what you are being treated for.

When aldesleukin is given as an 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. How many cycles of treatment you need will depend on the type of cancer you have and how it responds to the treatment. Your nurse can teach you to give the injection yourself at home or a family member can learn how to do it. You need to keep your aldesleukin in the fridge.

If you have aldesleukin 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 cannot have any vaccinations while you are having aldesleukin, or for 3 months after you have finished your treatment. You should tell your doctor if you have

• Shingles or exposure to someone with chickenpox (aldesleukin treatment may make shingles flare up)
• Heart disease

The side effects associated with aldesleukin are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, see the cancer drug side effects section or use the search box at the top of this page. Side effects may be more severe when aldesleukin is given through a drip because you have higher doses this way.

More than 10 in every 100 people have one or more of the side effects listed below.

Temporary drop in the number of blood cells made by the bone marrow, causing

• 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, sore throat, pain passing urine or feel cold and shivery 
• 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, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia).

Some of these side effects can be life threatening, particularly infections. You should contact your treatment centre if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Fatigue (tiredness) 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 but usually gets 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
• 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
• 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
• Aldesleukin may have a harmful effect on a developing baby – it is not advisable to become pregnant, breastfeed or father a child if you are having this drug. It is important to talk about contraception with your doctor or nurse before having the treatment if there is any chance of pregnancy

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 changes in heart rhythm (heart beat). These are quite uncommon and nearly always get better when treatment has stopped. You should tell your doctor if you have had heart problems before or if you have any of these side effects
• Pain and redness in the area of the injection – it is advised to regularly change the site that you give your injection to help prevent this
• Kidney changes that are mild and unlikely to cause symptoms may occur – they will almost certainly go back to normal when treatment is finished, but you will have regular blood tests to check how well your kidneys are working
• Cough and breathlessness
• A sore mouth
• Confusion, depression and extreme sleepiness – this is more common in older patients or people who have had depression before. Tell your doctor if you have these symptoms

A very small number of people may have hair thinning – this is more likely to happen with long courses or high doses of aldesleukin.

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment. Or you may have more side effects 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)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, live vaccines include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines 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.