Cardiotoxic Effects Following CAR-T Cell Therapy: A Literature Review.

IF 4.7 2区 医学 Q1 ONCOLOGY
Tony Joseph, Jimmy Sanchez, Ahmed Abbasi, Lili Zhang, R Alejandro Sica, Tim Q Duong
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引用次数: 0

Abstract

Purpose of review: This paper reviewed the current literature on incidence, clinical manifestations, and risk factors of Chimeric Antigen Receptor T-cell (CAR-T) cardiotoxicity.

Recent findings: CAR-T therapy has emerged as a groundbreaking treatment for hematological malignancies since FDA approval in 2017. CAR-T therapy is however associated with a few side effects, among which cardiotoxicity is of significant concern. There were only a few studies on CAR-T cardiotoxicity published to date with limited sample sizes, and their findings were heterogeneous. It was difficult to reach generalizable conclusions. CAR-T therapy was associated with significant risks for acute and subacute cardiotoxicity, as measured by echocardiograms, EKG, and blood biomarkers. Patients with cytokine release syndrome (CRS) grade 2 or higher were more likely to exhibit cardiotoxicity. The most prevalent cardiac events included hypotension-requiring inotropic or vasopressor support, tachycardia, heart failure/decompensation, atrial fibrillation, new or worsening cardiomyopathy, arrhythmia, myocarditis, cardiac arrest, and cardiovascular death. The most prevalent echocardiographic changes were systolic dysfunction and diastolic dysfunction, and abnormal echocardiogram findings. There were differences in findings between adult and pediatric patients. The long-term effects beyond a year post treatment remain largely unknown and long-term follow-up studies are warranted.

CAR-T细胞治疗后的心脏毒性作用:文献综述。
综述目的:本文综述了CAR-T细胞(嵌合抗原受体t细胞)心脏毒性的发病率、临床表现和危险因素。最近的发现:自2017年FDA批准以来,CAR-T疗法已成为血液系统恶性肿瘤的突破性治疗方法。然而,CAR-T疗法有一些副作用,其中心脏毒性是值得关注的。迄今为止,只有少数关于CAR-T心脏毒性的研究发表,样本量有限,而且他们的发现是异质性的。很难得出概括的结论。通过超声心动图、心电图和血液生物标志物测量,CAR-T治疗与急性和亚急性心脏毒性的显著风险相关。细胞因子释放综合征(CRS) 2级或以上的患者更有可能表现出心脏毒性。最常见的心脏事件包括降压性肌力或血管升压支持、心动过速、心力衰竭/失代偿、心房颤动、新发或恶化的心肌病、心律失常、心肌炎、心脏骤停和心血管性死亡。最常见的超声心动图变化是收缩功能障碍和舒张功能障碍,以及超声心动图异常。成人和儿童患者的结果存在差异。治疗后一年以上的长期影响仍不清楚,需要进行长期随访研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.50
自引率
0.00%
发文量
187
审稿时长
6-12 weeks
期刊介绍: This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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