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The association of cardiac arrhythmias with chimeric antigen receptor T cell therapy in hospitalised patients: Insights from National Inpatient Sample

Published:August 20, 2022DOI:https://doi.org/10.1016/j.ejca.2022.07.019
      Chimeric antigen receptor-T (CAR-T) cell therapy is a novel adoptive cellular therapy involving the use of CARs (recombinant fusion proteins) that activate T cells upon the recognition of specific antigens resulting in the killing of target cancer cells [
      • June C.H.
      • Sadelain M.
      Chimeric antigen receptor therapy.
      ,
      • Dai H.
      • Wang Y.
      • Lu X.
      • Han W.
      Chimeric antigen receptors modified T-cells for cancer therapy.
      ]. CD-19-specific CAR-T cell therapy has revolutionised the care of patients with refractory and relapsing haematological malignancies [
      • Neelapu S.S.
      • Locke F.L.
      • Bartlett N.L.
      • et al.
      Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma.
      ,
      • Schuster S.J.
      • Bishop M.R.
      • Tam C.S.
      • et al.
      Tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma.
      ]. However, CAR-T cell therapy has significant cardiac adverse effects including cardiac arrhythmias, heart failure, and QT prolongation [
      • Ghosh A.K.
      • Chen D.H.
      • Guha A.
      • Mackenzie S.
      • Walker J.M.
      • Roddie C.
      CAR T cell therapy-related cardiovascular outcomes and management: systemic disease or direct cardiotoxicity?.
      ,
      • Totzeck M.
      • Michel L.
      • Lin Y.
      • Herrmann J.
      • Rassaf T.
      Cardiotoxicity from chimeric antigen receptor-T cell therapy for advanced malignancies.
      ]. Current data about cardiovascular adverse events of CAR-T cell therapy are limited to small observational studies and case reports. In this report, we investigated the association of arrhythmias among hospitalised patients undergoing CAR-T cell therapy using a nationwide, contemporary administrative claims database. We hypothesised that patients undergoing CAR-T cell therapy will have a significant association with cardiac arrhythmias as compared to propensity-matched controls.
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