Incidence of MACE in Patients Treated With CAR-T Cell Therapy A Prospective Study

被引:16
作者
Lefebvre, Benedicte [1 ]
Kang, Yu [1 ]
Vakilpour, Azin [1 ]
Onoue, Takeshi [1 ]
Frey, Noelle V. [2 ]
Brahmbhatt, Priya [1 ]
Huang, Brian [1 ]
Oladuja, Kemi [1 ]
Koropeckyj-Cox, Daniel [1 ]
Wiredu, Courteney [1 ]
Smith, Amanda M. [1 ]
Chittams, Jesse [3 ]
Carver, Joseph [1 ,4 ]
Scherrer-Crosbie, Marielle [1 ,5 ]
机构
[1] Hosp Univ Penn, Dept Med, Div Cardiovasc Dis, Philadelphia, PA USA
[2] Hosp Univ Penn, Dept Med, Div Hematol & Oncol Dis, Philadelphia, PA USA
[3] Univ Penn, Perelman Sch Med, Dept Biostat Epidemiol & Informat, Philadelphia, PA USA
[4] Univ Penn, Abramson Canc Ctr, Perelman Sch Med, Philadelphia, PA USA
[5] Hosp Univ Penn, Dept Med, Div Cardiovasc Dis, 3400 Spruce St, Philadelphia, PA 19104 USA
来源
JACC: CARDIOONCOLOGY | 2023年 / 5卷 / 06期
关键词
cardiovascular; CAR-T cells; cardio-oncology; CYTOKINE RELEASE SYNDROME; MANAGEMENT; EVENTS;
D O I
10.1016/j.jaccao.2023.07.009
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND Previous retrospective studies have shown that chimeric antigen receptor T (CAR-T) cell therapy may be associated with major adverse cardiovascular events (MACE), especially in the context of cytokine-release syndrome (CRS) events. OBJECTIVES The aim of this prospective observational study was to define the occurrence of MACE in adults undergoing treatment with CAR-T cell therapy and identify associated risk factors.METHODS Vital signs, blood samples, and an echocardiogram were collected prior to and 2 days, 1 week, 1 month, and 6 months after CAR-T cell infusion, and charts were consulted at 12 months. In the event of CRS, echocardiography was repeated within 72 hours. MACE were defined as cardiovascular death, symptomatic heart failure, acute coronary syndrome, ischemic stroke, and de novo cardiac arrhythmia. RESULTS A total of 44 patients were enrolled (mean age 58 +/- 11 years, 77% men). The median follow-up duration was 487 days (Q1-Q3: 258-622 days). There were 24 episodes of CRS in 23 patients (52%) (13 grade 1,10 grade 2, and 1 grade 3), with a median time to CRS of 4 days. Two patients had MACE (heart failure with preserved ejection fraction and atrial fibrillation) within 1 year and 6 and 7 days after CAR-T cell infusion. There was no change in left ventricular ejection fraction, but a modest decrease in global longitudinal strain was noted. CONCLUSIONS There were few cardiac effects associated with contemporary CAR-T cell therapy. As MACE occurred after CRS episodes, aggressive treatment and close follow-up during CRS events are essential.
引用
收藏
页码:747 / 754
页数:8
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