Denileukin diftitox

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Recombinant fusion protein from interleukin-2 and the diphtheria toxin fragments A and B.

Pharmacodynamics (Effect)
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Denileukin Diftitox interacts with the highly affine forms of the IL-2 receptor (CD25-, CD122-, CD132 pos.) on lymphoma cells in CTCL, activated T- and B-lymphocytes as well as macrophages and thereby inhibits the cellular protein synthesis of these cells (cell death within a few hours).

Indication
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Persistent or recurrent cutaneous T-cell lymphomas expressing CD 25.

Pregnancy/nursing period
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Contraindicated in pregnancy and lactation (insufficient data available).

Dosage and method of use
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Therapy cycle with 9-18 mg/kg bw/day (in NaCl 0.9%) i.v. on 5 consecutive days. Before therapy, apply systemic antihistamines, e.g. Dimetinden (Fenistil). Repeat every 21 days.

Remember! Let infusion slowly, for at least 15-30 minutes! Only use infusion containers made of plastic (danger of loss of active substance due to sticking to the container wall in glass containers)!

Undesirable effects
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Frequent fever, chills, hypotonia, dehydration, nausea, vomiting, hypoalbuminaemia, anaemia, dyspnoea

Interactions
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Not known (insufficient data available)

Preparations
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Ontak (not approved in Germany; available from international pharmacies)

Note(s)
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Remember! Response rate according to phase III studies: 38% for CTCL (16% complete remission, 22% partial remission)!

Literature
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  1. Carretero-Margolis CD, Fivenson DP (2003) A complete and durable response to denileukin diftitox in a patient with mycosis fungoides. J Am Acad Dermatol 48: 275-276
  2. Frankel AE et al (2003) A phase II study of DT fusion protein denileukin diftitox in patients with fludarabine-refractory chronic lymphocytic leukemia. Clin Cancer Res 9: 3555-3561
  3. Paschal BR (2003) Remission of follicular non-Hodgkin's lymphoma with denileukin diftitox (ONTAK) after progression during rituximab, CHOP and fludarabine therapy. Leuk lymphoma 44: 731-733
  4. Prince HM et al (2003) Management of the primary cutaneous lymphomas. Australas J Dermatol 44: 227-240
  5. Smith BD, Wilson LD (2003) Management of mycosis fungoides: Part 2. treatment. Oncology 17: 1419-1428

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Last updated on: 29.10.2020