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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
Scholary Output:
Contribution to journal
Article
 Peer-review

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.

Publication Information

Output type

Scholary Output:
Contribution to journal
Article
 Peer-review

Original language

English (US)

Pages from-to (Number of pages)

Pages 97-109 (13 pages)

Journal (Volume, Issue Number)

JACC: CardioOncology (Volume 2, Issue 1)

Publication milestones

  • Published - 03/01/2020

Publication status

Published - 03/01/2020

Publication IDs

  • Scopus: 85084383017
  • ORCID: /0000-0003-0253-1174/work/110363097

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