Frontiers in Oncology (Jun 2021)
An Analysis of Cardiac Disorders Associated With Chimeric Antigen Receptor T Cell Therapy in 126 Patients: A Single-Centre Retrospective Study
- Kunming Qi,
- Kunming Qi,
- Kunming Qi,
- Zhiling Yan,
- Zhiling Yan,
- Zhiling Yan,
- Hai Cheng,
- Hai Cheng,
- Hai Cheng,
- Wei Chen,
- Wei Chen,
- Wei Chen,
- Ying Wang,
- Ying Wang,
- Ying Wang,
- Xue Wang,
- Xue Wang,
- Xue Wang,
- Jiang Cao,
- Jiang Cao,
- Jiang Cao,
- Huanxin Zhang,
- Huanxin Zhang,
- Huanxin Zhang,
- Wei Sang,
- Wei Sang,
- Wei Sang,
- Feng Zhu,
- Feng Zhu,
- Feng Zhu,
- Haiying Sun,
- Haiying Sun,
- Haiying Sun,
- Depeng Li,
- Depeng Li,
- Depeng Li,
- Qingyun Wu,
- Qingyun Wu,
- Qingyun Wu,
- Jianlin Qiao,
- Jianlin Qiao,
- Jianlin Qiao,
- Chunling Fu,
- Chunling Fu,
- Chunling Fu,
- Lingyu Zeng,
- Lingyu Zeng,
- Lingyu Zeng,
- Zhenyu Li,
- Zhenyu Li,
- Zhenyu Li,
- Junnian Zheng,
- Kailin Xu,
- Kailin Xu,
- Kailin Xu
Affiliations
- Kunming Qi
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Kunming Qi
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Kunming Qi
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Zhiling Yan
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Zhiling Yan
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Zhiling Yan
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Hai Cheng
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Hai Cheng
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Hai Cheng
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Wei Chen
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Wei Chen
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Wei Chen
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Ying Wang
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Ying Wang
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Ying Wang
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Xue Wang
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Xue Wang
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Xue Wang
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Jiang Cao
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Jiang Cao
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiang Cao
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Huanxin Zhang
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Huanxin Zhang
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Huanxin Zhang
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Wei Sang
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Wei Sang
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Wei Sang
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Feng Zhu
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Feng Zhu
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Feng Zhu
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Haiying Sun
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Haiying Sun
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Haiying Sun
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Depeng Li
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Depeng Li
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Depeng Li
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Qingyun Wu
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Qingyun Wu
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Qingyun Wu
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Jianlin Qiao
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Jianlin Qiao
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jianlin Qiao
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Chunling Fu
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Chunling Fu
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Chunling Fu
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Lingyu Zeng
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Lingyu Zeng
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Lingyu Zeng
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Zhenyu Li
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Zhenyu Li
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Zhenyu Li
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- Junnian Zheng
- Cancer Institute, Xuzhou Medical University, Xuzhou, China
- Kailin Xu
- Blood Diseases Institute, Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, China
- Kailin Xu
- Department of Hematology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Kailin Xu
- Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou, China
- DOI
- https://doi.org/10.3389/fonc.2021.691064
- Journal volume & issue
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Vol. 11
Abstract
IntroductionChimeric antigen receptor T (CAR-T) cells are effective in treating hematological malignancies. However, in patients receiving CAR-T therapy, data characterizing cardiac disorders are limited.Methods126 patients with hematologic malignancies receiving CAR-T cell therapy were analyzed to determine the impact of CAR-T therapy on occurrence of cardiac disorders, including heart failure, arrhythmias, myocardial infarction, which were defined by the Common Terminology Criteria for Adverse Events (CTCAE). Parameters related to cardiac disorders were detected including myocardial enzyme, NT-proBNP and ejection fraction (EF). Cardiovascular (CV) events included decompensated heart failure (HF), clinically significant arrhythmias and CV death.ResultsThe median age of patients was 56 years (6 to 72 years). 58% patients were male, 62% had multiple myeloma, 20% had lymphoma and 18% had ALL. 33 (26%) patients had cardiac disorders, most of which were grade 1-2. 13 patients (10%) were observed with cardiac disorders grade 3-5, which comprised 5(4%) patients with new-onset HF, 2 (2%) patients with new-onset arrhythmias, 4 (3%) patients with the acute coronary syndrome, 1(1%) patient with myocardial infarction and 1(1%) patient with left ventricular systolic dysfunction. There were 9 CV events (7%) including 6 decompensated heart failure, 1 clinically significant arrhythmias and 2 CV deaths. Among the 33 patients with cardiac disorders, the patients with cardiac disorders CTCAE grade 3-5 had higher grade CRS (grade ≥ 3) than those with cardiac disorders CTCAE grade ≤ 2 (P <0.001). More patients with cardiac disorders CTCAE grade 3-5 were observed in the cohort who did not receive corticosteroids and/or tocilizumab therapy timely comparing with those who received corticosteroids and/or tocilizumab therapy timely (P =0.0004).ConclusionsCardiac disorders CAR-T cell therapy were common and associated with occurrence of CRS. However, most cases were mild. For patients with CRS grade 3-5, timely administration of corticosteroids and/or tocilizumab can effectively prevent the occurrence and progression of cardiac disorders.
Keywords