医学
心脏毒性
嵌合抗原受体
心力衰竭
细胞因子释放综合征
背景(考古学)
免疫抑制
心肌病
免疫疗法
疾病
内科学
心脏病学
肿瘤科
癌症
免疫学
化疗
古生物学
生物
作者
Ashley Stein-Merlob,Sarju Ganatra,Eric H. Yang
标识
DOI:10.1016/j.hfc.2022.02.008
摘要
Chimeric antigen receptor (CAR) T-cell and bispecific T-cell engager (BiTE) therapies have revolutionized the treatment of refractory or relapsed leukemia and lymphoma. Increased use of these therapies has revealed signals of significant cardiotoxicity, including cardiomyopathy/heart failure, arrhythmia, myocardial injury, hemodynamic instability, and cardiovascular death mainly in the context of a profound inflammatory response to CAR T-cell antitumor effects known as cytokine release syndrome (CRS). Preexisting cardiovascular risk factors and disease may increase the risk of such cardiotoxicity. High index of suspicion and close monitoring is required for prompt recognition. Supportive hemodynamic care and targeted anti-IL-6 therapy, as well as possibly broader immunosuppression with corticosteroids, are the cornerstones of the management.
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