首页 | 本学科首页   官方微博 | 高级检索  
     


Cardiovascular events in patients treated with chimeric antigen receptor T-cell therapy for aggressive B-cell lymphoma
Authors:Raphael E. Steiner  Jose Banchs  Efstratios Koutroumpakis  Melody Becnel  Cristina Gutierrez  Paolo Strati  Chelsea C. Pinnix  Lei Feng  Gabriela Rondon  Catherine Claussen  Nicolas Palaskas  Kaveh Karimzad  Sairah Ahmed  Sattva S. Neelapu  Elizabeth Shpall  Michael Wang  Francisco Vega  Jason Westin  Loretta J. Nastoupil  Anita Deswal
Affiliation:1.Lymphoma and Myeloma, MD Anderson Cancer Center;2.Cardiology, MD Anderson Cancer Center;3.Critical Care& Respiratory Care, MD Anderson Cancer Center;4.Radiation Oncology, MD Anderson Cancer Center;5.Biostatistics, MD Anderson Cancer Center;6.Stem Cell Transplantation, MD Anderson Cancer Center and ;7.Hematophathology, MD Anderson Cancer Center, Houston, TX, USA
Abstract:Standard of care (SOC) chimeric antigen receptor (CAR) T-cell therapies such as axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) are associated with multisystem toxicities. There is limited information available about cardiovascular (CV) events associated with SOC axi-cel or tisa-cel. Patients with CV comorbidities, organ dysfunction, or lower performance status were often excluded in the clinical trials leading to their Food and Drug Adminsitration approval. An improved understanding of CV toxicities in the real-world setting will better inform therapy selection and management of patients receiving these cellular therapies. Here, we retrospectively reviewed the characteristics and outcomes of adult patients with relapsed/refractory large B-cell lymphoma treated with SOC axi-cel or tisa-cel. Among the 165 patients evaluated, 27 (16%) developed at least one 30-day (30-d) major adverse CV event (MACE). Cumulatively, these patients experienced 21 arrhythmias, four exacerbations of heart failure/cardiomyopathy, four cerebrovascular accidents, three myocardial infarctions, and one patient died due to myocardial infaction. Factors significantly associated with an increased risk of 30-d MACE included age ≥60 years, an earlier start of cytokine release syndrome (CRS), CRS ≥ grade 3, long duration of CRS, and use of tocilizumab. After a median follow-up time of 16.2 months (range, 14.3-19.1), the occurrence of 30-d MACE was not significantly associated with progression-free survival or with overall survival. Our results suggest that the occurrence of 30-d MACE is more frequent among patients who are elderly, with early, severe, and prolonged CRS. However, with limited follow-up, larger prospective studies are needed, and multidisciplinary management of these patients is recommended.
Keywords:
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号