Cardiovascular Disease and Chimeric Antigen Receptor Cellular Therapy

Overview

Journal Front Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2022 Oct 10

PMID 36211558

Authors

Anjali Rao

Andrew Stewart

Mahmoud Eljalby

Praveen Ramakrishnan

Larry D Anderson Jr

Farrukh T Awan

Alvin Chandra

Srilakshmi Vallabhaneni

Kathleen Zhang

Vlad G Zaha

Affiliations

Soon will be listed here.

Abstract

Chimeric antigen receptor T-cell (CAR T) therapy is a revolutionary personalized therapy that has significantly impacted the treatment of patients with hematologic malignancies refractory to other therapies. Cytokine release syndrome (CRS) is a major side effect of CAR T therapy that can occur in 70-90% of patients, with roughly 40% of patients at grade 2 or higher. CRS can cause an intense inflammatory state leading to cardiovascular complications, including troponin elevation, arrhythmias, hemodynamic instability, and depressed left ventricular systolic function. There are currently no standardized guidelines for the management of cardiovascular complications due to CAR T therapy, but systematic practice patterns are emerging. In this review, we contextualize the history and indications of CAR T cell therapy, side effects related to this treatment, strategies to optimize the cardiovascular health prior to CAR T and the management of cardiovascular complications related to CRS. We analyze the existing data and discuss potential future approaches.

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