Patel Nikita P, Doukas Peter G, Gordon Leo I, Akhter Nausheen
Department of Medicine, Northwestern Feinberg School of Medicine, 676 N. St. Clair St., Arkes Suite 2330, Chicago, IL, 60611, USA.
Division of Hematology and Oncology, Northwestern Feinberg School of Medicine, 675 N. St. Clair St. Ste 21-100, Chicago, IL, 60611, USA.
Curr Oncol Rep. 2021 May 3;23(7):78. doi: 10.1007/s11912-021-01068-0.
This review provides a contemporary overview of current studies outlining the incidence and characteristics of CAR T-cell cardiotoxicity in an effort to identify future directions for research and potential opportunities for prevention and intervention.
Cardiovascular events occurred in anywhere between 10 and 36% of patients in CAR T-cell clinical trials, ranging from tachycardia, hypotension, arrhythmia, decreased left ventricular systolic function to cardiogenic shock and death. Cardiac events are more often associated higher grades (> 2) of cytokine release syndrome and frequently proceeded by an elevated troponin. There is a growing recognition of cardiotoxicities of CAR T-cell therapy but has a limited study in this area. The mechanism of left ventricular dysfunction due to CAR T-cell therapy is also unknown. As CAR T-cell use expands, it becomes imperative to truly understand the mechanism behind cardiac injury and to assess long-term follow-up data as this will allow for surveillance, early intervention, and potentially prevention of cardiotoxicity.
本综述对当前研究进行了当代概述,这些研究概述了嵌合抗原受体(CAR)T细胞心脏毒性的发生率和特征,旨在确定未来的研究方向以及预防和干预的潜在机会。
在CAR T细胞临床试验中,10%至36%的患者发生了心血管事件,范围从心动过速、低血压、心律失常、左心室收缩功能下降到心源性休克和死亡。心脏事件更常与较高等级(>2级)的细胞因子释放综合征相关,并且常常在肌钙蛋白升高之前出现。人们对CAR T细胞疗法的心脏毒性认识不断提高,但该领域的研究有限。CAR T细胞疗法导致左心室功能障碍的机制也尚不清楚。随着CAR T细胞的使用不断扩大,真正了解心脏损伤背后的机制并评估长期随访数据变得至关重要,因为这将有助于监测、早期干预并可能预防心脏毒性。