嵌合抗原受体T细胞治疗的心脏毒性研究进展

Advances on cardiotoxicity in chimeric antigen receptor T⁃cell therapy

嵌合抗原受体(chimeric antigen receptor,CAR)T细胞疗法是一种新型的免疫疗法,近年来成为肿瘤领域的热点。尤其CD19 CAR-T细胞在难治/复发血液恶性肿瘤治疗中取得显著疗效。然而治疗伴随着明显的毒性,细胞因子释放综合征(CRS)和神经毒性被广泛报道,而心血管毒性定的真实特征及机制仍不清楚。本文综述了目前对CD19 CAR-T细胞治疗并发心血管毒性事件的认识,介绍CAR-T细胞疗法心脏毒性的临床表现、发生机制、预防及治疗策略等研究进展,旨在最大限度的减少心血管并发症的风险,使这种潜在挽救生命的治疗方法让更多的癌症患者获益。

As a new type of immunotherapy,Chimeric antigen receptor T cell therapy has become a hot spot in tumor field in recent years.The CD19 CAR⁃T cell therapy achieved significant results particularly in the treatment of refractory and recurrent hematologic malignancies.However,the treatment is accompanied by signifi⁃cant toxicities,the most widely reported being cytokine release syndrome(CRS)and neurotoxicity.While the true characteristics and mechanisms of cardiotoxicity remain unclear.This article summarizes the current acquaintance with cardiotoxicity of CD19 CAR⁃T cell therapy by introducing its mechanisms,clinical manifestation,prevention and treatment advances,aiming to minimize the risk of cardioascular complications,make more cancer patients benefit from the potential life⁃saving treatment.