Inflammation and acute cardiotoxicity in adult hematological patients treated with CAR-T cells: results from a pilot proof-of-concept study

Autor: Massimiliano Camilli, Marcello Viscovo, Tamara Felici, Luca Maggio, Federico Ballacci, Giacomo Carella, Alice Bonanni, Priscilla Lamendola, Lorenzo Tinti, Antonio Di Renzo, Giulia Coarelli, Eugenio Galli, Giovanna Liuzzo, Francesco Burzotta, Rocco Antonio Montone, Federica Sorà, Simona Sica, Stefan Hohaus, Gaetano Antonio Lanza, Filippo Crea, Antonella Lombardo, Giorgio Minotti
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Cardio-Oncology, Vol 10, Iss 1, Pp 1-11 (2024)
Druh dokumentu: article
ISSN: 2057-3804
DOI: 10.1186/s40959-024-00218-0
Popis: Abstract Aims Chimeric Antigen Receptor-T (CAR-T) cell infusion is a rapidly evolving antitumor therapy; however, cardiovascular (CV) complications, likely associated with cytokine release syndrome (CRS) and systemic inflammation, have been reported to occur. The CARdio-Tox study aimed at elucidating incidence and determinants of cardiotoxicity related to CAR-T cell therapy. Methods Patients with blood malignancies candidate to CAR-T cells were prospectively evaluated by echocardiography at baseline and 7 and 30 days after infusion. The study endpoints were i) incidence of cancer therapy-related cardiac dysfunction (CTRCD), CTRCD were also balanced for any grade CRS, but CTRCD occurred of Cardiology Guidelines on Cardio-Oncology (decrements of left ventricular ejection fraction (LVEF) or global longitudinal strain (GLS) and/or elevations of cardiac biomarkers (high sensitivity troponin I, natriuretic peptides) and ii), correlations of echocardiographic metrics with inflammatory biomarkers. Results Incidence of CTRCD was high at 7 days (59,3%), particularly in subjects with CRS. The integrated definition of CTRCD allowed the identification of the majority of cases (50%). Moreover, early LVEF and GLS decrements were inversely correlated with fibrinogen and interleukin-2 receptor levels (p always ≤ 0.01). Conclusions There is a high incidence of early CTRCD in patients treated with CAR-T cells, and a link between CTRCD and inflammation can be demonstrated. Dedicated patient monitoring protocols are advised. Graphical Abstract
Databáze: Directory of Open Access Journals
Externí odkaz: