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

Autor: Mazetto RASV; Medicine Department, Amazonas State University, Manaus, Brazil., Monteiro SON; Medicine Department, Redentor University Center, Itaperuna, Brazil., Bulhões E; Medicine Department, Faculty of Higher Superior of the Amazon Reunida, Redenção, Brazil., Defante MLR; Medicine Department, Redentor University Center, Itaperuna, Brazil., Antunes VLJ; Medicine Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil., Balieiro CCA; Medicine Department, Amazonas State University, Manaus, Brazil., Feitoza L; Medicine Department, Fametro University Center, Manaus, Brazil., Ferreira ALC; Medicine Department, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil., Carvalho AM; Medicine Department, Ribeirão Preto Medical School of University of São Paulo, Ribeirão Preto, Brazil., Guida C; Division of Cardiology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: European journal of haematology [Eur J Haematol] 2024 Aug 22. Date of Electronic Publication: 2024 Aug 22.
DOI: 10.1111/ejh.14289
Abstrakt: 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.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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