Cardiovascular Events After Chimeric Antigen Receptor T-Cell Therapy for Advanced Hematologic Malignant Neoplasms: A...

Area of Science:

• Oncology
• Cardiology
• Immunotherapy

Background:

• Cardiotoxicity from chimeric antigen receptor (CAR) T-cell therapy is not well understood, as clinical trials often exclude high-risk cardiovascular patients.
• Real-world data on cardiovascular complications in CAR T-cell recipients are limited.

Purpose of the Study:

• To determine the prevalence of adverse cardiovascular events in adult patients receiving CAR T-cell therapy for advanced hematologic malignancies.

Main Methods:

• A systematic literature search was conducted across major databases (MEDLINE, Embase, Cochrane Library, Google Scholar) until February 2024.
• Included observational studies of adult CAR T-cell recipients with advanced hematologic malignancies that reported cardiovascular complications.
• Meta-analysis of single proportions using random-effect models was performed to calculate pooled prevalence estimates.

Main Results:

• Thirteen studies with 1528 patients were analyzed. Pooled prevalence included: ventricular arrhythmia (0.66%), supraventricular arrhythmia (7.79%), left ventricular dysfunction (8.68%), heart failure (3.87%), myocardial infarction (0.62%), and cardiovascular death (0.63%).
• All-cause mortality prevalence was 30.01%.
• Sensitivity analyses confirmed these findings.

Conclusions:

• CAR T-cell therapy is associated with a low prevalence of ventricular arrhythmias, myocardial infarction, and cardiovascular death in the short to midterm follow-up.
• Left ventricular dysfunction and supraventricular arrhythmias are the most frequent cardiovascular complications.
• Cardiovascular surveillance should prioritize monitoring ejection fraction and supraventricular arrhythmias.