High Sensitivity Troponin T and NT-proBNP in Patients Receiving Chimeric Antigen Receptor (CAR) T-Cell Therapy

Authors

Jiun-Ruey Hu^{1, †,} , Ameet Patel^2, , Shi Huang¹, Yan Ru Su¹, Kimberly B. Dahlman^2, , Kelsey Tomasek¹, Yueli Zhang¹, Richard T. O’Neil³, Jamye F. O’Neal⁴, Isik Turker¹, Douglas B. Johnson², Joe-Elie Salem^{5, 6}, Javid J. Moslehi^{1, 6}, Olalekan Oluwole^{2, *,}

¹Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

²Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA

³Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA

⁴Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA

⁵Department of Pharmacology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France

⁶Cardio-Oncology Program, Vanderbilt University Medical Center, Nashville, TN, USA

^†

Division of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA

^*Corresponding author. Email: olalekan.oluwole@vumc.org

DOI

10.2991/chi.k.210718.001How to use a DOI?

Keywords

Chimeric antigen receptor T cell; troponin; BNP; cardiotoxicity; lymphoma

Abstract

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 (P_Wilcox = 0.0002) and day 7 (P_Wilcox = 2.7 × 10⁻⁵), and the degree of elevation differed by the presence of grade 2 CRS (P_interaction = 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.

Copyright

© 2021 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Jiun-Ruey Hu
AU  - Ameet Patel
AU  - Shi Huang
AU  - Yan Ru Su
AU  - Kimberly B. Dahlman
AU  - Kelsey Tomasek
AU  - Yueli Zhang
AU  - Richard T. O’Neil
AU  - Jamye F. O’Neal
AU  - Isik Turker
AU  - Douglas B. Johnson
AU  - Joe-Elie Salem
AU  - Javid J. Moslehi
AU  - Olalekan Oluwole
PY  - 2021
DA  - 2021/08/02
TI  - High Sensitivity Troponin T and NT-proBNP in Patients Receiving Chimeric Antigen Receptor (CAR) T-Cell Therapy
JO  - Clinical Hematology International
SP  - 96
EP  - 102
VL  - 3
IS  - 3
SN  - 2590-0048
UR  - https://doi.org/10.2991/chi.k.210718.001
DO  - 10.2991/chi.k.210718.001
ID  - Hu2021
ER  -