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Assessment of Chimeric Antigen Receptor T Cell-Associated Toxicities Using an Acute Lymphoblastic Leukemia Patient-Derived Xenograft Mouse Model

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Cardiotoxic Effects Following CAR-T Cell Therapy: A Literature Review.

Tony Joseph^1,2, Jimmy Sanchez¹, Ahmed Abbasi³

¹Department of Radiology, Albert Einstein College of Medicine and the Montefiore Medical Center, 111 East 210Th Street, Bronx, NY, 10461, USA.

Current Oncology Reports

|January 21, 2025

Summary

This summary is machine-generated.

Chimeric Antigen Receptor T-cell (CAR-T) therapy, while effective for blood cancers, poses significant risks of cardiotoxicity. Patients with severe cytokine release syndrome (CRS) face higher cardiac event risks, necessitating further long-term studies.

Keywords:

Atrial arrhythmia Blood biomarkers Cancer immunotherapy Cardiomyopathy Cardiotoxicity Cytokine release syndrome (CRS)Diastolic dysfunction ECG EKG Echocardiogram Hypotension Troponin (TNT)

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Area of Science:

Oncology
Cardiology
Immunotherapy

Background:

Chimeric Antigen Receptor T-cell (CAR-T) therapy is a revolutionary treatment for hematological malignancies.
CAR-T therapy is associated with significant side effects, notably cardiotoxicity.

Purpose of the Study:

To review the current literature on the incidence, clinical manifestations, and risk factors of CAR-T therapy-associated cardiotoxicity.
To synthesize findings from limited and heterogeneous studies on CAR-T cardiotoxicity.

Main Methods:

Literature review of published studies on CAR-T cardiotoxicity.
Analysis of clinical manifestations, incidence, and risk factors.
Examination of cardiac events and echocardiographic findings.

Main Results:

CAR-T therapy is linked to substantial risks of acute and subacute cardiotoxicity.
Higher-grade cytokine release syndrome (CRS) (grade 2 or higher) is associated with increased cardiotoxicity risk.
Common cardiac events include hypotension, tachycardia, heart failure, arrhythmias, and cardiomyopathy; echocardiographic changes involve systolic and diastolic dysfunction.

Conclusions:

CAR-T cardiotoxicity is a significant concern requiring careful monitoring.
Differences in cardiotoxicity exist between adult and pediatric populations.
Long-term effects of CAR-T therapy on the heart remain largely unknown, warranting further investigation.