The cardiotoxic effects of CAR-T cell therapy: An updated systematic review and meta-analysis

IF 2.3 3区医学 Q2 HEMATOLOGY European Journal of Haematology Pub Date : 2024-08-22 DOI:10.1111/ejh.14289

Roberto A. S. V. Mazetto, Sarah O. N. Monteiro, Elísio Bulhões, Maria L. R. Defante, Vanio L. J. Antunes, Caroline Cristine Almeida Balieiro, Luanna Feitoza, André L. C. Ferreira, Amadeu M. Carvalho, Camila Guida

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Abstract

Background

Chimeric antigen receptor T-cell (CAR-T) therapy has shown promise in treating hematologic malignancies, yet its potential cardiotoxic effects require thorough investigation.

Objectives

We aim to conduct a systematic review and meta-analysis to examine the cardiotoxic effects of CAR-T therapy in adults with hematologic malignancies.

Methods

We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for studies reporting cardiovascular outcomes, such as arrhythmias, heart failure, and reduced left ventricle ejection fraction (LVEF).

Results

Our analysis of 20 studies involving 4789 patients revealed a 19.68% incidence rate of cardiovascular events, with arrhythmias (7.70%), heart failure (5.73%), and reduced LVEF (3.86%) being the most prevalent. Troponin elevation was observed in 23.61% of patients, while NT-Pro-BNP elevation was observed in 9.4. Subgroup analysis showed higher risks in patients with pre-existing conditions, such as atrial arrhythmia (OR 3.12; p < .001), hypertension (OR 1.85; p = .002), previous heart failure (OR 3.38; p = .003), and coronary artery disease (OR 2.80; p = .003).

Conclusion

Vigilant cardiovascular monitoring is crucial for patients undergoing CAR-T therapy to enhance safety and treatment efficacy.Novelty Statements.

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CAR-T 细胞疗法的心脏毒性效应：最新系统综述和荟萃分析。

背景：嵌合抗原受体T细胞（CAR-T）疗法在治疗血液系统恶性肿瘤方面前景广阔，但其潜在的心脏毒性效应仍需深入研究：我们旨在开展一项系统综述和荟萃分析，研究CAR-T疗法对成年血液恶性肿瘤患者心脏毒性的影响：我们检索了PubMed、Embase和Cochrane对照试验中央登记册中报告心血管结局的研究，如心律失常、心力衰竭和左心室射血分数（LVEF）降低：我们对涉及 4789 名患者的 20 项研究进行了分析，发现心血管事件的发生率为 19.68%，其中心律失常（7.70%）、心力衰竭（5.73%）和 LVEF 降低（3.86%）最为常见。23.61%的患者出现肌钙蛋白升高，9.4%的患者出现NT-Pro-BNP升高。亚组分析表明，患有房性心律失常等原有疾病的患者风险更高（OR 3.12；P 结论：对心血管疾病的警惕性和预防措施对心血管疾病的治疗至关重要：对接受 CAR-T 疗法的患者进行严密的心血管监测对提高安全性和疗效至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Haematology 医学-血液学

CiteScore

5.50

自引率

0.00%

发文量

168

审稿时长

4-8 weeks

期刊介绍： European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.