Risk analysis of cardiovascular toxicity in patients with lymphoma treated with CD19 CAR T cells
Abstract Background Anti-CD19 chimeric antigen receptor (CAR) T cell therapy is a common, yet highly efficient, cellular immunotherapy for lymphoma. However, many recent studies have reported on its cardiovascular (CV) toxicity. This study analyzes the cardiotoxicity of CD19 CAR T cell therapy in th...
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BMC
2025-01-01
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| Series: | Journal of Translational Medicine |
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| Online Access: | https://doi.org/10.1186/s12967-024-06035-4 |
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| author | Yang Liu Xiaoshuang Yuan Xu Yang Bo Yang Guangyang Liu Xiao Xu Sanbin Wang Zhixu He Feiqing Wang Yanju Li |
| author_facet | Yang Liu Xiaoshuang Yuan Xu Yang Bo Yang Guangyang Liu Xiao Xu Sanbin Wang Zhixu He Feiqing Wang Yanju Li |
| author_sort | Yang Liu |
| collection | DOAJ |
| description | Abstract Background Anti-CD19 chimeric antigen receptor (CAR) T cell therapy is a common, yet highly efficient, cellular immunotherapy for lymphoma. However, many recent studies have reported on its cardiovascular (CV) toxicity. This study analyzes the cardiotoxicity of CD19 CAR T cell therapy in the treatment of lymphoma for providing a more valuable reference for clinicians. Methods The PubMed, Embase, Cochrane library, and Web of Science databases were comprehensively searched from the time of their establishment to May 2024. The ClinicalTrials.gov English database is a comprehensive repository of the original studies of CD19 CAR T cell therapy and associated adverse outcomes, such as arrhythmia, CV events, and hypotension, in patients with lymphoma. The Cochrane Collaboration tool and the Newcastle–Ottawa Scale (NOS) were used to assess the quality of the included original studies. For RCTs, the Cochrane Collaboration tool was used to assess the risk of bias. For non-randomized studies, the risk of bias was assessed using the NOS quality assessment scale. Results A risk analysis of two randomized controlled trials and nine cohort studies, totaling 1379 patients with lymphoma receiving CD19 CAR-T, is conducted. The incidences for all-cause mortality, CV events, and hypotension were found to be 17.8%, 17.8%, and 52.8%, respectively. Additionally, the incidences of heart failure (HF), cardiomyopathy, cardiac arrest, and other CV events are 3%, 0.6%, 1.3%, and 2.5%, respectively. In addition to cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) as adverse events, patients treated with CD19 CAR T cells are also at risk of CV events. The most common CV events are arrhythmia and HF. Our further analysis showed that the incidence of CV events was 28.7% in the elderly and 13.5% in adults. The incidence of CV events in the elderly was higher than that in adults, and it was statistically significant. Furthermore, the incidence of CV events and hypotension is strongly associated with patients with CRS. Conclusion Therefore, clinicians should pay close attention to the occurrence of such CV events and take timely prevention and intervention measures to further improve the safety of CD19 CAR T cell therapy. |
| format | Article |
| id | doaj-art-80636424b0aa4a11a9dd67a0d2d07e81 |
| institution | Kabale University |
| issn | 1479-5876 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Translational Medicine |
| spelling | doaj-art-80636424b0aa4a11a9dd67a0d2d07e812025-01-05T12:44:36ZengBMCJournal of Translational Medicine1479-58762025-01-0123111510.1186/s12967-024-06035-4Risk analysis of cardiovascular toxicity in patients with lymphoma treated with CD19 CAR T cellsYang Liu0Xiaoshuang Yuan1Xu Yang2Bo Yang3Guangyang Liu4Xiao Xu5Sanbin Wang6Zhixu He7Feiqing Wang8Yanju Li9Clinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineDepartment of Hematology Oncology, Affiliated Hospital of Guizhou Medical UniversityClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineFourth Medical Center, General Hospital of People’s Liberation Army: Chinese PLA General HospitalPeople’s Liberation Army Joint Logistic Support Force 920, HospitalCenter of Tissue Engineering and Stem Cell Research, Guizhou Medical UniversityClinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineDepartment of Hematology Oncology, Affiliated Hospital of Guizhou Medical UniversityAbstract Background Anti-CD19 chimeric antigen receptor (CAR) T cell therapy is a common, yet highly efficient, cellular immunotherapy for lymphoma. However, many recent studies have reported on its cardiovascular (CV) toxicity. This study analyzes the cardiotoxicity of CD19 CAR T cell therapy in the treatment of lymphoma for providing a more valuable reference for clinicians. Methods The PubMed, Embase, Cochrane library, and Web of Science databases were comprehensively searched from the time of their establishment to May 2024. The ClinicalTrials.gov English database is a comprehensive repository of the original studies of CD19 CAR T cell therapy and associated adverse outcomes, such as arrhythmia, CV events, and hypotension, in patients with lymphoma. The Cochrane Collaboration tool and the Newcastle–Ottawa Scale (NOS) were used to assess the quality of the included original studies. For RCTs, the Cochrane Collaboration tool was used to assess the risk of bias. For non-randomized studies, the risk of bias was assessed using the NOS quality assessment scale. Results A risk analysis of two randomized controlled trials and nine cohort studies, totaling 1379 patients with lymphoma receiving CD19 CAR-T, is conducted. The incidences for all-cause mortality, CV events, and hypotension were found to be 17.8%, 17.8%, and 52.8%, respectively. Additionally, the incidences of heart failure (HF), cardiomyopathy, cardiac arrest, and other CV events are 3%, 0.6%, 1.3%, and 2.5%, respectively. In addition to cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) as adverse events, patients treated with CD19 CAR T cells are also at risk of CV events. The most common CV events are arrhythmia and HF. Our further analysis showed that the incidence of CV events was 28.7% in the elderly and 13.5% in adults. The incidence of CV events in the elderly was higher than that in adults, and it was statistically significant. Furthermore, the incidence of CV events and hypotension is strongly associated with patients with CRS. Conclusion Therefore, clinicians should pay close attention to the occurrence of such CV events and take timely prevention and intervention measures to further improve the safety of CD19 CAR T cell therapy.https://doi.org/10.1186/s12967-024-06035-4CD19Chimeric antigen receptor T cellsCAR-T therapyLymphomaCardiovascular toxicity |
| spellingShingle | Yang Liu Xiaoshuang Yuan Xu Yang Bo Yang Guangyang Liu Xiao Xu Sanbin Wang Zhixu He Feiqing Wang Yanju Li Risk analysis of cardiovascular toxicity in patients with lymphoma treated with CD19 CAR T cells Journal of Translational Medicine CD19 Chimeric antigen receptor T cells CAR-T therapy Lymphoma Cardiovascular toxicity |
| title | Risk analysis of cardiovascular toxicity in patients with lymphoma treated with CD19 CAR T cells |
| title_full | Risk analysis of cardiovascular toxicity in patients with lymphoma treated with CD19 CAR T cells |
| title_fullStr | Risk analysis of cardiovascular toxicity in patients with lymphoma treated with CD19 CAR T cells |
| title_full_unstemmed | Risk analysis of cardiovascular toxicity in patients with lymphoma treated with CD19 CAR T cells |
| title_short | Risk analysis of cardiovascular toxicity in patients with lymphoma treated with CD19 CAR T cells |
| title_sort | risk analysis of cardiovascular toxicity in patients with lymphoma treated with cd19 car t cells |
| topic | CD19 Chimeric antigen receptor T cells CAR-T therapy Lymphoma Cardiovascular toxicity |
| url | https://doi.org/10.1186/s12967-024-06035-4 |
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