CAR-T（CAR-T）细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
CAR-T 细胞治疗的心脏毒性作用：更新的系统综述和荟萃分析
英文原题：The cardiotoxic effects of CAR-T cell therapy: An updated systematic review and meta-analysis.
查看英文原题
The cardiotoxic effects of CAR-T cell therapy: An updated systematic review and meta-analysis.
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研究概要
对接受 CAR-T 治疗的患者进行警惕的心血管监测对于提高安全性和治疗效果至关重要。创新性声明。
研究思路结论见上方概要
背景
CAR-T 细胞疗法在治疗血液系统恶性肿瘤方面已显示出前景，但其潜在的心脏毒性效应需要深入探究。
目的
我们旨在开展一项系统综述和meta分析，以考察CAR-T 疗法在成人血液系统恶性肿瘤中的心脏毒性效应。
方法
我们检索了PubMed、Embase和Cochrane对照试验中心注册库，以查找报告心血管结局（如心律失常、心力衰竭和左心室射血分数（LVEF）降低）的研究。
结果
我们对20项研究、共4789例患者的分析显示，心血管事件发生率为19.68%，其中最常见的是心律失常（7.70%）、心力衰竭（5.73%）和LVEF降低（3.86%）。23.61%的患者观察到肌钙蛋白升高，9.4%的患者观察到NT-Pro-BNP升高。亚组分析显示，既往存在某些疾病的患者风险更高，如房性心律失常（OR 3.12；p < .001）、高血压（OR 1.85；p = .002）、既往心力衰竭（OR 3.38；p = .003）和冠状动脉疾病（OR 2.80；p = .003）。
展开英文摘要原文
BACKGROUND
Chimeric antigen receptor T-cell (CAR-T) therapy has shown promise in treating hematologic malignancies, yet its potential cardiotoxic effects require thorough investigation.
OBJECTIVES
We aim to conduct a systematic review and meta-analysis to examine the cardiotoxic effects of CAR-T therapy in adults with hematologic malignancies.
METHODS
We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for studies reporting cardiovascular outcomes, such as arrhythmias, heart failure, and reduced left ventricle ejection fraction (LVEF).
RESULTS
Our analysis of 20 studies involving 4789 patients revealed a 19.68% incidence rate of cardiovascular events, with arrhythmias (7.70%), heart failure (5.73%), and reduced LVEF (3.86%) being the most prevalent. Troponin elevation was observed in 23.61% of patients, while NT-Pro-BNP elevation was observed in 9.4. Subgroup analysis showed higher risks in patients with pre-existing conditions, such as atrial arrhythmia (OR 3.12; p < .001), hypertension (OR 1.85; p = .002), previous heart failure (OR 3.38; p = .003), and coronary artery disease (OR 2.80; p = .003).
CONCLUSION
Vigilant cardiovascular monitoring is crucial for patients undergoing CAR-T therapy to enhance safety and treatment efficacy.Novelty Statements.
论文信息
- 作者
- Mazetto RASV、Monteiro SON、Bulhões E、Defante MLR、Antunes VLJ、Balieiro CCA、Feitoza L、Ferreira ALC
- 第一作者单位
- Medicine Department, Amazonas State University, Manaus, Brazil.Brazil
- 通讯作者单位
- Division of Cardiology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil.Brazil
- 文献类型
- 系统综述 · 荟萃分析
- 期刊
- European journal of haematology2024 Dec
- 原文标识
- PubMed 39171519 · DOI 10.1111/ejh.14289