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Published in: Current Hematologic Malignancy Reports 2/2020

01-04-2020 | Hypotension | T-Cell and Other Lymphoproliferative Malignancies (J Zain, Section Editor)

The Cardiovascular Complications of Chimeric Antigen Receptor T Cell Therapy

Authors: Faizi A. Jamal, Samer K. Khaled

Published in: Current Hematologic Malignancy Reports | Issue 2/2020

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Abstract

Purpose of Review

Chimeric antigen receptor T cell therapy is gaining clinical use in the management of B cell lymphomas. As the use of this unique treatment option increases, its associated toxicities will require recognition and treatment. In this review, we aim to discuss the cardiovascular toxicities of chimeric antigen receptor T cell therapy and our approach to their clinical management.

Recent Findings

Cardiotoxicity may be due to direct or indirect effects of infused chimeric antigen receptor T cells. The cytokine release syndrome has been described extensively in the literature. Studies have also reported cardiovascular dysfunction including hypotension, left ventricular dysfunction, heart failure, and cardiogenic shock in the setting of cytokine release syndrome.

Summary

While there are no standardized guidelines for the treatment of cytokine release syndrome or associated cardiotoxicity, we present our current clinical practices. Further research is indicated into the pathophysiology of therapy-associated cardiac dysfunction and effective management strategies to optimize patient outcomes.
Literature
7.
go back to reference • Ganatra S, Carver JR, Hayek SS, Ky B, Leja MJ, Lenihan DJ, et al. Chimeric antigen receptor T-cell therapy for cancer and heart: JACC Council Perspectives. J Am Coll Cardiol. 2019;74(25):3153–63. https://doi.org/10.1016/j.jacc.2019.10.049. The authors have incorporated expert consensus perspectives from the Cardio-Oncology Section of the American College of Cardiology into clinical practice when managing patients undergoing chimeric antigen receptor T cell therapy.CrossRefPubMedPubMedCentral • Ganatra S, Carver JR, Hayek SS, Ky B, Leja MJ, Lenihan DJ, et al. Chimeric antigen receptor T-cell therapy for cancer and heart: JACC Council Perspectives. J Am Coll Cardiol. 2019;74(25):3153–63. https://​doi.​org/​10.​1016/​j.​jacc.​2019.​10.​049. The authors have incorporated expert consensus perspectives from the Cardio-Oncology Section of the American College of Cardiology into clinical practice when managing patients undergoing chimeric antigen receptor T cell therapy.CrossRefPubMedPubMedCentral
Metadata
Title
The Cardiovascular Complications of Chimeric Antigen Receptor T Cell Therapy
Authors
Faizi A. Jamal
Samer K. Khaled
Publication date
01-04-2020
Publisher
Springer US
Published in
Current Hematologic Malignancy Reports / Issue 2/2020
Print ISSN: 1558-8211
Electronic ISSN: 1558-822X
DOI
https://doi.org/10.1007/s11899-020-00567-4

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