Description:
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<jats:bold>Background:</jats:bold>
Previous retrospective studies have shown that CAR-T cell therapy may be associated with major adverse cardiovascular events (MACE) especially in context of cytokine release syndrome (CRS) events.
<jats:bold>Objectives.</jats:bold>
The aim of this prospective observational study was to define the occurrence of MACE in adults undergoing treatment with CAR-T cell therapy and identify associated risk factors.
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<jats:bold>Methods:</jats:bold>
Vital signs, blood samples and an echocardiogram were collected prior to, two days, one week, one month, and six months after CAR-T cell infusion, and chart consulted at 12 months. In the event of CRS, an echocardiogram was repeated within 72 hours. MACE were defined as cardiovascular death, symptomatic heart failure, acute coronary syndrome, ischemic stroke, and de novo cardiac arrhythmia.
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<jats:bold>Results:</jats:bold>
A total of 44 patients were enrolled (58 ±11 years-old, 77 % male). The median follow-up was 487 days (258-622 days). There were 24 episodes of CRS in 23 patients (52%) (13 with grade 1, 10 with grade 2, and one with grade 3) with a median time to CRS of 4 days. Two patients had MACE (HFpEF and atrial fibrillation) within one year, six and seven days after CAR-T cell infusion respectively. There was no change in left ventricular ejection fraction (LVEF), however, a modest decrease in global longitudinal strain (GLS) was noted.
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<jats:bold>Conclusions:</jats:bold>
There were few cardiac effects associated with contemporary CAR-T cell therapy. A small decline in LV mechanics was detected. As MACE occurred after CRS episodes, aggressive treatment and close follow-up during CRS events are essential.
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