CAR T Cell Therapy–Related Cardiovascular Outcomes and Management: Systemic Disease or Direct Cardiotoxicity?

Arjun K. Ghosh, Daniel H. Chen, Avirup Guha, Strachan Mackenzie, J. Malcolm Walker, Claire Roddie

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

CD19-specific chimeric antigen receptor (CAR) T cell therapies have shown remarkable early success in highly refractory and relapsing hematological malignancies. However, this potent therapy is accompanied by significant toxicity. Cytokine release syndrome and neurotoxicity are the most widely reported, but the true extent and characteristics of cardiovascular toxicity remain poorly understood. Thus far, adverse cardiovascular effects observed include sinus tachycardia and other arrhythmias, left ventricular systolic dysfunction, profound hypotension, and shock requiring inotropic support. The literature regarding cardiovascular toxicities remains sparse; prospective studies are needed to define the cardiac safety of CAR T cell therapies to optimally harness their potential. This review summarizes the current understanding of the potential cardiovascular toxicities of CD19-specific CAR T cell therapies, outlines a proposed cardiac surveillance protocol for patients receiving this new treatment, and provides a roadmap of the future direction of cardio-oncology research in this area.
Original languageEnglish (US)
Pages (from-to)97-109
Number of pages13
JournalJACC: CardioOncology
Volume2
Issue number1
DOIs
StatePublished - Mar 1 2020

Keywords

  • cardiomyopathy
  • cytokine release syndrome
  • immunotherapy
  • leukemia
  • lymphoma

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