High Sensitivity Troponin T and NT-proBNP in Patients Receiving Chimeric Antigen Receptor (CAR) T-Cell Therapy.
High Sensitivity Troponin T and NT-proBNP in Patients Receiving Chimeric Antigen Receptor (CAR) T-Cell Therapy.
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CAR - T细胞治疗患者的高敏感性肌钙蛋白T和NT-proBNP
DOI：
10.2991/chi.k.210718.001
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发表时间：
2021-09
影响因子：
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通讯作者：
Oluwole O
中科院分区：
文献类型：
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作者：
Hu JR;Patel A;Huang S;Su YR;Dahlman KB;Tomasek K;Zhang Y;O'Neil RT;O'Neal JF;Turker I;Johnson DB;Salem JE;Moslehi JJ;Oluwole O
回顾性研究表明，嵌合抗原受体T细胞（CAR T）治疗可能导致心脏损伤，但尚未系统或前瞻性评估。在这项对40例接受CAR T治疗的患者进行的前瞻性研究中，我们系统地测量了基线和CAR T治疗后第1天、第7天和第21天的高敏肌钙蛋白T（hsTropT）和N末端B钠尿肽原（NTproBNP）。使用重复测量方差分析检查时间点和细胞因子释放综合征（CRS）状态相关的生物标志物升高。hsTropT不随时间或2级CRS的存在而不同。基线时中位hsTropT为12.1 ng/L [四分位距（IQR）：9.2，20.1]，第1天为13.1 ng/L（IQR：9.6，24.2），第7天为11.9 ng/L（IQR：9.6，18.0），第21天为15.3 ng/L（10.8，20.2）。相比之下，NTproBNP在第1天（PWilcox = 0.0002）和第7天（PWilcox = 2.7 × 10−5）升高，升高程度因2级CRS的存在而异（Pinteraction = 0.002）。基线时中位NTproBNP为179 pg/mL（IQR：116，325），第1天为357 pg/mL（IQR：98，813），第7天为420 pg/mL（IQR：239，1242），第21天为177 pg/mL（IQR：80，278）。总之，hsTropTl在CAR T治疗后的各个时间点没有差异，但NTproBNP在第7天升高，其预后意义应该是未来研究的目标，因为这种治疗的适应症扩大。
Retrospective studies suggest that chimeric antigen receptor T-cell (CAR T) therapy may lead to cardiac injury, but this has not been assessed systematically or prospectively. In this prospective study of 40 patients who received CAR T, we systematically measured high-sensitivity troponin T (hsTropT) and N-terminal pro-B natriuretic peptide (NTproBNP) at baseline and on day 1, days 7, and 21 after CAR T. Biomarker elevations with respect to timepoint and cytokine release syndrome (CRS) status were examined using repeated measure analysis of variance. hsTropT did not differ with time or with the presence of grade 2 CRS. Median hsTropT was 12.1 ng/L [interquartile range (IQR): 9.2, 20.1] at baseline, 13.1 ng/L (IQR: 9.6, 24.2) at day 1, 11.9 ng/L (IQR: 9.6, 18.0) at day 7, and 15.3 ng/L (10.8, 20.2) at day 21. In contrast, NTproBNP rose on day 1 (PWilcox = 0.0002) and day 7 (PWilcox = 2.7 × 10−5), and the degree of elevation differed by the presence of grade 2 CRS (Pinteraction = 0.002). Median NTproBNP was 179 pg/mL (IQR: 116, 325) at baseline, 357 pg/mL (IQR: 98, 813) at day 1, 420 pg/mL (IQR: 239, 1242) at day 7, and 177 pg/mL (IQR: 80, 278) at day 21. In conclusion, hsTropT l did not differ across timepoints after CAR T therapy, but NTproBNP rose at day 7, the prognostic implications of which should be the target of future research, as the indications for this therapy expand.