CAR T-cell therapies have been approved for the treatment of several hematologic malignancies. The treatment has been a subject of concern for researchers who have reported adverse events such as cytokine release syndrome, hematotoxicity, and neurotoxicity. Cytokine release syndrome is perhaps the most widely known.
According to a recent article in Healio, CAR T-cell therapies have been poorly understood and underreported, mostly due to lack of patient data from prominent clinical trials.
In an attempt to bring a portion of published data current, Dr. David Koeckerling and colleagues at Heidelberg University Hospital in Germany searched 13 databases and created a meta-analysis. Meta-analysis is defined as the summation of all studies included in a systematic review and reported as the overall result.
The team used data from cardiovascular events relating to individuals who:
• were diagnosed with late-stage hematologic malignancies
• had been administered CAR T-cell therapy
• were adults with advanced malignant neoplasms (tumors)
Additionally, studies were required to present an evaluation of a minimum of one cardiovascular outcome such as:
• cardiovascular death
• heart failure occurrence
• ventricular arrhythmia
• myocardial infarction
• supraventricular arrhythmia
• reduction in left ventricular ejection
A total of 1,528 patients with a median age of 61 years were included in the study. The primary outcome of the study was to be the prevalence of adverse cardiovascular events. The majority of patients, 80%, were diagnosed with lymphoma and 85% had been administered anthracycline therapy. The median number of days for follow-up totaled 487 within a range of 294 to 530 days.
Results of the Study
The cardiovascular mortality statistics registered 0.6%. The researchers wrote that after undergoing CAR T-cell therapy, only a few patients experienced any cardiovascular events. Left ventricular dysfunction was the most common adverse cardiovascular event with a rating of 8.6%.
Seven studies were also evaluated for death due to any cause. A random-effects meta-analysis assessed all-cause mortality at 30.01%.
About Study Limitations
The researchers acknowledged the study’s limitations such as most of the studies being retrospective. Therefore, there was a lack of pretreatment patient workups. Also, surveillance was inconsistent after CAR-T with minimal follow-up. The team recommended that studies assessing events associated with cardiovascular patients are needed.
Learn more about this research here.
blood cancer cancer treatment CAR T-cell therapy leukemia lymphoma research treatment
Last modified: October 30, 2024
