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Chimeric Antigen Receptor T-Cell Therapy for Cancer and Heart
- Source :
- Journal of the American College of Cardiology. 74:3153-3163
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Chimeric antigen receptor (CAR) T-cell therapy has significantly advanced the treatment of patients with relapsed and refractory hematologic malignancies and is increasingly investigated as a therapeutic option of other malignancies. The main adverse effect of CAR T-cell therapy is potentially life-threatening cytokine release syndrome (CRS). Clinical cardiovascular (CV) manifestations of CRS include tachycardia, hypotension, troponin elevation, reduced left ventricular ejection fraction, pulmonary edema, and cardiogenic shock. Although insults related to CRS toxicity might be transient and reversible in most instances in patients with adequate CV reserve, they can be particularly challenging in higher-risk, often elderly patients with pre-existing CV disease. As the use of CAR T-cell therapy expands to include a wider patient population, careful patient selection, pre-treatment cardiac evaluation, and CV risk stratification should be considered within the CAR T-cell treatment protocol. Early diagnosis and management of CV complications in patients with CRS require awareness and multidisciplinary collaboration.
- Subjects :
- Cardiotoxicity
medicine.medical_specialty
Ejection fraction
business.industry
Cardiogenic shock
030204 cardiovascular system & hematology
Pulmonary edema
medicine.disease
Chimeric antigen receptor
03 medical and health sciences
Cytokine release syndrome
0302 clinical medicine
Internal medicine
Cardiology
Medicine
Chimeric Antigen Receptor T-Cell Therapy
030212 general & internal medicine
Cardiology and Cardiovascular Medicine
business
Adverse effect
Subjects
Details
- ISSN :
- 07351097
- Volume :
- 74
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi...........99fdfe9a151cdfa5edbac8cd91e94825