The cardiotoxic effects of CAR‐T cell therapy: An updated systematic review and meta‐analysis

Abstract

BackgroundChimeric antigen receptor T‐cell (CAR‐T) therapy has shown promise in treating hematologic malignancies, yet its potential cardiotoxic effects require thorough investigation.ObjectivesWe aim to conduct a systematic review and meta‐analysis to examine the cardiotoxic effects of CAR‐T therapy in adults with hematologic malignancies.MethodsWe 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).ResultsOur 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).ConclusionVigilant cardiovascular monitoring is crucial for patients undergoing CAR‐T therapy to enhance safety and treatment efficacy.Novelty Statements.