Division of Hematology-Oncology, University of Nebraska Medical Center, Omaha, NE.
Division of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
JCO Oncol Pract. 2023 Jun;19(6):331-342. doi: 10.1200/OP.22.00713. Epub 2023 Mar 17.
The field of malignant hematology is transforming with novel immunotherapeutic approaches. Unfortunately, quality of life, treatment efficacy, and life expectancy are negatively affected by cardiotoxic side effects of treatment. To date, the exact mechanism and incidence of cardiotoxicity associated with these therapies is unclear. These events are believed to be triggered or occur concurrently with cytokine release syndrome. Furthermore, there are no formal guidelines to provide evaluation, treatment, and surveillance. We aim to synthesize available literature with updates on the cardiotoxic effects of novel therapies used in malignant hematologic disorders, with a focus on chimeric antigen receptor T-cell therapy and bispecific T-cell engager therapy, along with a proposed algorithm that may guide pretreatment evaluation, monitoring during treatment, and post-treatment surveillance.
恶性血液病领域正在发生变化,新的免疫治疗方法层出不穷。不幸的是,治疗的心脏毒性副作用会降低生活质量、治疗效果和预期寿命。迄今为止,这些治疗方法相关的心脏毒性的确切机制和发生率尚不清楚。人们认为这些事件是由细胞因子释放综合征引发或同时发生的。此外,目前还没有正式的指南来提供评估、治疗和监测。我们旨在综合现有文献,更新恶性血液病中新型治疗方法的心脏毒性作用,重点关注嵌合抗原受体 T 细胞疗法和双特异性 T 细胞衔接器疗法,并提出一个可能指导治疗前评估、治疗期间监测和治疗后随访的算法。