Transient left ventricular dysfunction following chimeric antigen receptor T‐cell‐mediated encephalopathy: A form of stress cardiomyopathy

Abstract

Chimeric antigen receptor (CAR) T-cell therapy represents a new strategy in treating lymphoid malignancies, such as relapsed-refractory diffuse large B-cell lymphoma (DLBCL). Several toxicities including cytokine release syndrome (CRS), neurotoxicity, and cardiovascular toxicity have been linked to CAR T-cell therapy. Transient impairment in left ventricular systolic function is described after CAR-T, however, the mechanism remains poorly understood. This paper reports the clinical presentation and outcome of two patients with relapsed-refractory DLBCL who experienced encephalopathy and CRS following CAR T-cell therapy and developed transient left ventricular dysfunction consistent with stress cardiomyopathy.

Identification of Potential Targets of Stress Cardiomyopathy by a Machine Learning Algorithm

“…In contrast, the proportion of B cells did not differ significantly within subgroups, thereby indicating prolonged inflammation duration during the progressive phase of the disease [32]. Interestingly, a review of past case studies revealed that patients treated with CAR-T in oncology therapy show manifestations similar to those of stress cardiomyopathy [33], thus suggesting that surface T cells may be involved in the development of stress cardiomyopathy and that early treatment with immunosuppressive agents does improve the prognosis of stress cardiomyopathy [34]. These findings may suggest a unique role of immunity in stress cardiomyopathy.…”