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Introduction <p>Chimeric antigen receptor (CAR) T-cell therapy is a novel immunotherapy that has transformed the management landscape of hematologic malignancies, including lymphoma, leukemia, and multiple myeloma. By repurposing genetically engineered T-cells to target tumor antigens, CAR-T cell therapies offer better remission in refractory disease. There have been several reports of an increasing association with cardiovascular toxicities.</p> Methodology <p>In this review, we focus on the cardiotoxic effects of CAR T-cell therapies, including their mechanisms, clinical outcomes, presentations, and management strategies. Reported events include arrhythmias, heart failure, myocardial infarction, and worsening of pre-existing cardiac diseases, often due to cytokine release syndrome (CRS). Early recognition and risk stratification are essential, with electrocardiography, echocardiography, and proper history-taking serving as key tools to identify high-risk patients. This review also explores management strategies, including supportive care, guideline-directed heart failure therapy, and prompt treatment of CRS with agents such as tocilizumab.</p> Conclusion <p>Future research should prioritize the identification of inflammatory biomarkers predictive of cardiotoxicity, the development of standardized monitoring protocols, and the exploration of cardioprotective strategies to improve the safety and outcomes in patients undergoing CAR T-cell therapy.</p>

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Chimeric Antigen Receptor (CAR) T-Cell Therapy-Induced Cardiotoxicity: A Narrative Review of Mechanisms, Clinical Presentations, and Strategies for Optimization

  • 期刊论文

  • 发表日期：

    2025年10月9日

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  • Ikponmwosa Jude Ogieuhi,
  • Victor Oluwatomiwa Ajekiigbe,
  • Enawayon Timothy Agenge,
  • Olumide Damilola Akinmoju,
  • Efosa P. Iyawe,
  • Samuel Taiwo Ajewole,
  • Christopher Abiodun Adegbesan,
  • Komolafe Babajide Ayodeji,
  • Edidiong Sylvanus Enyeneokpon,
  • Chidera Stanley Anthony

摘要

Introduction

Chimeric antigen receptor (CAR) T-cell therapy is a novel immunotherapy that has transformed the management landscape of hematologic malignancies, including lymphoma, leukemia, and multiple myeloma. By repurposing genetically engineered T-cells to target tumor antigens, CAR-T cell therapies offer better remission in refractory disease. There have been several reports of an increasing association with cardiovascular toxicities.

Methodology

In this review, we focus on the cardiotoxic effects of CAR T-cell therapies, including their mechanisms, clinical outcomes, presentations, and management strategies. Reported events include arrhythmias, heart failure, myocardial infarction, and worsening of pre-existing cardiac diseases, often due to cytokine release syndrome (CRS). Early recognition and risk stratification are essential, with electrocardiography, echocardiography, and proper history-taking serving as key tools to identify high-risk patients. This review also explores management strategies, including supportive care, guideline-directed heart failure therapy, and prompt treatment of CRS with agents such as tocilizumab.

Conclusion

Future research should prioritize the identification of inflammatory biomarkers predictive of cardiotoxicity, the development of standardized monitoring protocols, and the exploration of cardioprotective strategies to improve the safety and outcomes in patients undergoing CAR T-cell therapy.