Aps Associated With Immunotherapy

Immunotherapy using interleukin-2 (IL-2), ainterferon or both, for patients with melanoma may induce increased levels of antithyroid microsomal and antithyroglobulin antibodies which may persist for months [104-106] as well as the induction of other autoantibodies [107],

Becker et al. [108] reported that immunotherapy in patients with cancer may be associated with the induction of aPL. Thirty melanoma patients were studied and 2 out of 4 treated with «-interferon alone (50%) and 3 out of 8 (37.5%) treated with IL-2 and «interferon (37.5%) developed aPL. In this group, aPL elevations were detected on «-interferon alone.

In the 5 patients with increased aPL, all showed a prolongation of the partial thromboplastin time and 4/5 (80%) had DVT, which in one patient was followed by a pulmonary embolus.

Naldi et al. [109] then reviewed 97 consecutive cases of melanoma and found one with increased aPL and also documented another with a superficial melanoma who had a history of recurrent spontaneous abortions and cerebrovascular accident.

The mechanism by which interferon particularly induces aPL is unknown, but may include alteration in endothelial cell integrity, induced by cytokines [110].

9. aPL FOLLOWING CHRONIC GRAFT-VERSUS-HOST DISEASE: ALLOGENEIC BONE-MARROW TRANSPLANTATION

aPL have been described in several patients after allogeneic bone-marrow transplantation in association with graft-versus-host disease [104-105]. In the one patient documented [105], it was thought that the severe thrombocytopenia may have been associated with the presence of aPL.

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