Title:Cardiovascular Toxicities with Chimeric Antigen Receptor T-cell Therapy
Volume: 19
Issue: 1
Author(s): Jashan Gill*
Affiliation:
- Department of Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
- Department
of Medicine, Northwestern McHenry Hospital, McHenry, IL, USA
Keywords:
CAR T-cell, Cardio-oncology, cytokine release syndrome, cardiomyopathy, cardiotoxicity, chimeric antigen receptor, CD19, BCMA.
Abstract: Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable efficacy in treating
highly refractory and relapsing hematological malignancies in pediatric and adult patients.
However, this promising therapy is limited by severe and potentially life-threatening toxicities. Cytokine
release syndrome (CRS) is the most commonly observed of these toxicities. The cardiovascular
manifestations of CRS include tachycardia, hypotension, left ventricular dysfunction, arrhythmias,
troponin elevation, cardiogenic shock, and pulmonary edema. Recent data suggest that
cardiotoxicities may be transient and reversible in younger patients with few cardiac comorbidities;
however, cardiotoxicities may be fatal in older patients with significant cardiac risk factors. The
literature remains sparse regarding long-term cardiotoxicities associated with CAR-T cell therapy.
Furthermore, consensus guidelines for monitoring and prevention of cardiotoxicities remain illdefined.
Therefore, this review will detail the cardiovascular toxicities of CAR T-cell therapy seen
in clinical trials and observational studies, summarize treatment approaches for CRS, outline the
currently adopted surveillance protocols for CAR T-cell associated cardiotoxicity, and explore the
future directions of research in this rapidly emerging field.
