Cardiovascular disease and chimeric antigen receptor cellular therapy

Area of Science:

• Oncology
• Immunotherapy
• Cardiology

Background:

• Chimeric antigen receptor T-cell (CAR T) therapy is a groundbreaking personalized treatment for refractory hematologic malignancies.
• Cytokine release syndrome (CRS), a significant adverse event, affects 70-90% of patients, with ~40% experiencing grade 2 or higher.
• CRS-induced inflammation can lead to severe cardiovascular complications, including troponin elevation, arrhythmias, and impaired left ventricular function.

Purpose of the Study:

• To review the history, indications, and side effects of CAR T-cell therapy.
• To outline strategies for optimizing cardiovascular health before CAR T-cell therapy.
• To discuss current and future management approaches for CRS-related cardiovascular complications.

Main Methods:

• Systematic review of existing literature on CAR T-cell therapy and CRS.
• Analysis of emerging practice patterns for managing cardiovascular complications.
• Discussion of pre-therapy cardiovascular optimization and post-therapy management.

Main Results:

• CAR T-cell therapy has transformed hematologic malignancy treatment but carries a high risk of CRS.
• Cardiovascular complications are frequent and serious sequelae of CRS.
• Standardized management guidelines are lacking, but clinical practices are evolving.

Conclusions:

• Effective management of CRS-induced cardiovascular complications is critical for patient safety in CAR T-cell therapy.
• Further research and guideline development are needed to standardize care.
• Optimizing patient cardiovascular health pre-therapy and implementing timely interventions are key to improving outcomes.