Key result
CAR T-cell and BiTE therapies are linked to significant cardiotoxicity driven by cytokine release syndrome.
T-cell immunotherapies can cause severe cardiotoxicity, often linked to cytokine release syndrome, necessitating vigilant monitoring and targeted immunosuppressive management.
Chimeric antigen receptor (CAR) T-cell and bispecific T-cell engager (BiTE) therapies have revolutionized the treatment of refractory or relapsed leukemia and lymphoma. Increased use of these therapies has revealed signals of significant cardiotoxicity, including cardiomyopathy/heart failure, arrhythmia, myocardial injury, hemodynamic instability, and cardiovascular death mainly in the context of a profound inflammatory response to CAR T-cell antitumor effects known as cytokine release syndrome (CRS). Preexisting cardiovascular risk factors and disease may increase the risk of such cardiotoxicity. High index of suspicion and close monitoring is required for prompt recognition. Supportive hemodynamic care and targeted anti-IL-6 therapy, as well as possibly broader immunosuppression with corticosteroids, are the cornerstones of the management.
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Stein-Merlob et al. (2022) conducted a review in Refractory or relapsed leukemia and lymphoma. Chimeric antigen receptor (CAR) T-cell and bispecific T-cell engager (BiTE) therapies was evaluated on Cardiotoxicity (cardiomyopathy/heart failure, arrhythmia, myocardial injury, hemodynamic instability, cardiovascular death). CAR T-cell and BiTE therapies are associated with significant cardiotoxicity driven by cytokine release syndrome, requiring close monitoring and targeted anti-IL-6 or immunosuppressive therapy.
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