Division of Cardiology, Department of Medicine, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA.
Department of Hematology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA.
Curr Hematol Malig Rep. 2020 Apr;15(2):130-132. doi: 10.1007/s11899-020-00567-4.
Chimeric antigen receptor T cell therapy is gaining clinical use in the management of B cell lymphomas. As the use of this unique treatment option increases, its associated toxicities will require recognition and treatment. In this review, we aim to discuss the cardiovascular toxicities of chimeric antigen receptor T cell therapy and our approach to their clinical management.
Cardiotoxicity may be due to direct or indirect effects of infused chimeric antigen receptor T cells. The cytokine release syndrome has been described extensively in the literature. Studies have also reported cardiovascular dysfunction including hypotension, left ventricular dysfunction, heart failure, and cardiogenic shock in the setting of cytokine release syndrome. While there are no standardized guidelines for the treatment of cytokine release syndrome or associated cardiotoxicity, we present our current clinical practices. Further research is indicated into the pathophysiology of therapy-associated cardiac dysfunction and effective management strategies to optimize patient outcomes.
嵌合抗原受体 T 细胞疗法在 B 细胞淋巴瘤的治疗中得到了越来越多的临床应用。随着这种独特治疗方法的应用增加，其相关毒性需要被识别和治疗。在这篇综述中，我们旨在讨论嵌合抗原受体 T 细胞治疗的心血管毒性及其临床管理方法。
心脏毒性可能是由于输注的嵌合抗原受体 T 细胞的直接或间接作用。细胞因子释放综合征在文献中已有广泛描述。研究还报告了心血管功能障碍，包括细胞因子释放综合征时的低血压、左心室功能障碍、心力衰竭和心源性休克。虽然目前还没有细胞因子释放综合征或相关心脏毒性的标准化治疗指南，但我们提出了当前的临床实践。需要进一步研究治疗相关心脏功能障碍的病理生理学和有效的管理策略，以优化患者的预后。
