A Case of the Aggravation of Peritonitis Carcinomatosa due to the Intraperitoneal Interleukin-2 Administration

Hiroaki Ohnishi, Kiyotaka Okuno, Tetsuhiko Nakamura, Yasuaki Silayama, Masatoshi Ozaki, Masayuki Yasutomi

The First Department of Surgery, Kinki University School of Medicine

We reported a patient who had peritonitis carcinomatosa because of gastric cancer and in whom aggravation of clinical symptoms and rapid growth of the tumor occurred together with an increase in immunological suppression after intermittent intraperitonel administration of interleukin-2 (IL-2, 8×10⁵ JRU, twice a week). While high lymphokine activated killer (LAK) activity was detected in peritoneal exudate cell (PEC) in this patient before IL-2 administration, the activity fell significantly after IL-2 administration, and the prostaglandin E₂ level in the ascitic fluid increased markedly. Analysis of the PEC subpopulation revealed that monocyte/macrophages were dominant and the CD3 and CD16 positive fractions were decreased in the PEC due to the IL-2 administration. Enlargement of a mass in the abdomen and increase in ascites occurred in this patient together with the marked reduction in immunological suppression. The patient expired on the 25th day of IL-2 administration. We examined the factors aggravating the clinical symptoms in this patient, though over our treatments and also discussed the criteria for administration of IL-2 to patients with peritonitis carcinomatosa.

Key words
peritonitis carcinomatosa, interleukin-2, intraperitoneal administration

Reprint requests
Hiroaki Ohnishi First Department of Surgery, Kinki University School of Medicine
377-2 Ohno-Higashi, Osaka-Sayama, 579 JAPAN

Accepted
December 12, 1990

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