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. 2023 May 18;141(20):2452-2459.
doi: 10.1182/blood.2022017579.

How I approach optimization of patients at risk of cardiac and pulmonary complications after CAR T-cell therapy

Cristina Gutierrez  1 , Tomas G Neilan  2 , Natalie S Grover  3
Affiliations

How I approach optimization of patients at risk of cardiac and pulmonary complications after CAR T-cell therapy

Cristina Gutierrez et al. Blood. .

Abstract

Chimeric antigen receptor (CAR) T cells have transformed the care for patients with hematologic malignancies. Patients treated with CAR T cells may experience cardiovascular and pulmonary complications, which primarily occur in the setting of cytokine release syndrome. In addition, many patients considered for CAR T-cell therapy have preexisting cardiac and pulmonary comorbidities. Among patients with good functional status, these conditions should not prevent patients from being offered these lifesaving therapies. In this article, we use a case-based approach to discuss how we evaluate and optimize conditions for patients with cardiac and pulmonary risk factors before CAR T-cell therapy and manage cardiac and pulmonary complications that may arise with treatment.

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Conflict of interest statement

Conflict-of-interest disclosure: C.G. has served on an advisory board for Legend Biotech and Janssen and received research support from RevImmune. T.G.N. has received grant funding from AstraZeneca and Bristol Myers Squibb and has been a consultant for H3 Biomedicine, Genentech, Roche, BMS, and Sanofi. N.S.G. has served on an advisory board or consulted for Novartis, Kite, Seattle Genetics, ADC Therapeutics, and Tessa Therapeutics.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Evaluation and optimization of patients with cardiac and pulmonary comorbidities before CAR T-cell therapy.
Figure 2.
Figure 2.
Assessment and considerations of patients with cardiac and pulmonary comorbidities and cardiovascular complications during CRS.
See this image and copyright information in PMC

Comment in

References

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