Efficacy and Safety of IL-2 injection for the treatment of childhood solid tumors or lymphoma with malignant pleural effusion, ascites and pericardial effusion

Abstract Background Currently, no available coherent management protocol exists for pediatric cancers associated with pleural effusion, ascites, and pericardial effusion. This study aimed to retrospectively present our experience in treating pediatric cancer patients with pleural effusion, ascites, and pericardial effusion using interleukin-2 (IL-2) and dexamethasone (DEX) intracavitary injections. Methods Between January 1st, 2008 and December 31st, 2020, medical reports of patients diagnosed with solid tumors or lymphoma were checked to identify those with concurrent > 2 cm pleural effusion and/or ascites and/or pericardial effusion. Patients diagnosed with effusions and treated with IL-2 were identified as being in the effusion group. Meanwhile, patients with the same primary tumors and effusions but did not receive interleukin 2 injection were reviewed and classified as the control group. Results Forty patients with solid tumors and Sixty-six patients with lymphoma were further diagnosed with pleural effusion, ascites, or pericardial effusion. A total of eighty-five patients received IL-2 injection while the remaining twenty-one did not. When lymphoma and solid tumor patients were combined, the Kaplan Meier analysis revealed a significant difference between the two groups, with p<0.01 for event free survival (EFS) and p<0.01 for overall survival (OS), both of which had p<0.01. Hazard ratio was found to be 0.344 for OS and 0.352 for EFS. Conclusions This retrospective study illustrates that thoracic, intraperitoneal, or pericardial injection of DEX plus IL-2 can be an effective and safe treatment for pediatric cancers with pleural effusion, ascites, and pericardial effusion.