Vascular leak syndrome: A side effect of immunotherapy

Roxana Baluna, Ellen S. Vitetta

Research output: Contribution to journalReview articlepeer-review

239 Scopus citations


The major dose-limiting toxicity of interleukin-2 (IL-2) and of immunotoxin (IT) therapies is vascular leak syndrome (VLS). VLS is characterized by an increase in vascular permeability accompanied by extravasation of fluids and proteins resulting in interstitial edema and organ failure. Manifestations of VLS include fluid retention, increase in body weight, peripheral edema, pleural and pericardial effusions, ascites, anasarca and, in severe form, signs of pulmonary and cardiovascular failure. Symptoms are highly variable among patients and the causes are poorly understood. The pathogenesis of endothelial cell (EC) damage is complex and can involve activation or damage to ECs and leukocytes, release of cytokines and of inflammatory mediators, alteration in cell-cell and cell-matrix adhesion and in cytoskeleton function. VLS restricts the doses of IL-2 and of ITs which can be administered to humans and, in some cases, necessitates the cessation of therapy. This review discusses the diversity of clinical manifestation, possible mechanisms and therapeutic modalities for VLS induced by IL-2 and ITs.

Original languageEnglish (US)
Pages (from-to)117-132
Number of pages16
Issue number2-3
StatePublished - Oct 1997


  • Endothelial cells
  • IL-2
  • Immunotoxins
  • Vascular leak

ASJC Scopus subject areas

  • Pharmacology


Dive into the research topics of 'Vascular leak syndrome: A side effect of immunotherapy'. Together they form a unique fingerprint.

Cite this