Cardiac adverse events after Chimeric Antigen Receptor (CAR) T cell therapies: an updated systematic review and meta-analysis.
CAR T-cell cardiotoxicity
Cancer immunotherapy
Cardiac biomarkers
Cardio-oncology
Cardiotoxicity
Cardiovascular events
Chimeric antigen receptor cardiotoxicity
Chimeric antigen receptor t-cells
Cytokine release syndrome
Journal
Cardio-oncology (London, England)
ISSN: 2057-3804
Titre abrégé: Cardiooncology
Pays: England
ID NLM: 101689938
Informations de publication
Date de publication:
20 Aug 2024
20 Aug 2024
Historique:
received:
01
06
2024
accepted:
22
07
2024
medline:
21
8
2024
pubmed:
21
8
2024
entrez:
20
8
2024
Statut:
epublish
Résumé
Chimeric antigen receptor (CAR) T-cell therapy is a new revolutionary method for treating refractory or relapsed hematologic malignancies, CAR T-cell therapy has been associated with cytokine release syndrome (CRS) and cardiotoxicity. We directed a systematic review and meta-analysis to determine the incidence and predictors of cardiovascular events (CVE) with CAR T-cell therapy. We investigated PubMed, Embase, Cochrane Library, and ClinicalTrials.gov for studies reporting cardiovascular outcomes in CAR-T cell recipients. The study protocol was listed in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42023478602). Twenty-three studies were included in this study. The pooled incidence of CVE was 54% for arrhythmias, 30% for heart failure, 20% for cardiomyopathy, 10% for acute coronary syndrome, and 7% for cardiac arrest. Patients with CVE had a higher incidence of cytokine release syndrome grade ≥ 2 (RR 2.36, 95% CI 1.86-2.99). The incidence of cardiac mortality in our meta-analysis was 2% (95% CI: 1%-3%). Left ventricular ejection fraction decline was greater in the CVE group (-9.4% versus -1.5%, p < 0.001). Cardiac biomarkers like BNP, CRP, creatinine, and ferritin were also elevated. CAR T-cell therapy commonly leads to cardiotoxicity, mediated by cytokine release syndrome. Vigilant monitoring and tailored treatments are crucial to mitigate these effects. Importantly, there's no significant difference in cardiac mortality between groups, suggesting insights for optimizing preventive interventions and reducing risks after CAR T-cell therapy.
Identifiants
pubmed: 39164789
doi: 10.1186/s40959-024-00252-y
pii: 10.1186/s40959-024-00252-y
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
52Informations de copyright
© 2024. The Author(s).
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