The cardiotoxic effects of CAR‐T cell therapy: An updated systematic review and meta‐analysis

Author:

Mazetto Roberto A. S. V.1ORCID,Monteiro Sarah O. N.2,Bulhões Elísio3,Defante Maria L. R.2,Antunes Vanio L. J.4,Balieiro Caroline Cristine Almeida1,Feitoza Luanna5,Ferreira André L. C.6,Carvalho Amadeu M.7,Guida Camila8

Affiliation:

1. Medicine Department Amazonas State University Manaus Brazil

2. Medicine Department Redentor University Center Itaperuna Brazil

3. Medicine Department Faculty of Higher Superior of the Amazon Reunida Redenção Brazil

4. Medicine Department Federal University of Health Sciences of Porto Alegre Porto Alegre Brazil

5. Medicine Department Fametro University Center Manaus Brazil

6. Medicine Department Pontifícia Universidade Católica do Paraná Curitiba Brazil

7. Medicine Department Ribeirão Preto Medical School of University of São Paulo Ribeirão Preto Brazil

8. Division of Cardiology Dante Pazzanese Institute of Cardiology São Paulo Brazil

Abstract

AbstractBackgroundChimeric antigen receptor T‐cell (CAR‐T) therapy has shown promise in treating hematologic malignancies, yet its potential cardiotoxic effects require thorough investigation.ObjectivesWe aim to conduct a systematic review and meta‐analysis to examine the cardiotoxic effects of CAR‐T therapy in adults with hematologic malignancies.MethodsWe searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for studies reporting cardiovascular outcomes, such as arrhythmias, heart failure, and reduced left ventricle ejection fraction (LVEF).ResultsOur analysis of 20 studies involving 4789 patients revealed a 19.68% incidence rate of cardiovascular events, with arrhythmias (7.70%), heart failure (5.73%), and reduced LVEF (3.86%) being the most prevalent. Troponin elevation was observed in 23.61% of patients, while NT‐Pro‐BNP elevation was observed in 9.4. Subgroup analysis showed higher risks in patients with pre‐existing conditions, such as atrial arrhythmia (OR 3.12; p < .001), hypertension (OR 1.85; p = .002), previous heart failure (OR 3.38; p = .003), and coronary artery disease (OR 2.80; p = .003).ConclusionVigilant cardiovascular monitoring is crucial for patients undergoing CAR‐T therapy to enhance safety and treatment efficacy.Novelty Statements.

Publisher

Wiley

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