Table 1 Patient baseline characteristics (overall and according to the occurrence of cancer therapy-related cardiac dysfunction)
| Â | Overall population 27 patients (100%) | CTRCD 16 patients (59,3%) | No CTRCD 11 patients (40,7%) | P value |
|---|---|---|---|---|
Demographics | Â | Â | Â | Â |
Age, years [mean ± standard deviation] | 60.5 ± 10.4 | 58.8 ± 11.7 | 63.1 ± 7.9 | 0.260 |
Female sex [n, (%)] | 9 (33.3) | 8 (88) | 1 [11] | 0.042 |
Cardiovascular risk factors | Â | Â | Â | Â |
Hypertension [n, (%)] | 20 (74.1) | 10 (62.5) | 10 (90.1) | 0.183 |
Diabetes [n, (%)] | 4 (14.8) | 2 (12.5) | 2 (18.2) | 1,000 |
Smoking [n, (%)] | 12 (44.4) | 6 (37.5) | 6 (54.5) | 0,452 |
Dyslipidemia [n, (%)] | 4 (14.8) | 3 (18.8) | 2 (18.2) | 1,000 |
Previous history of IHD [n, (%)] | 0 (0) | 0 (0) | 0 (0) | Â |
Electrocardiographic parameters | Â | Â | Â | Â |
Heart rate, bpm [mean ± standard deviation] | 84.1 ± 16.5 | 86.1 ± 13.6 | 80.5 ± 21.8 | 0.586 |
PR duration, milliseconds [mean ± standard deviation] | 156.0 ± 32.8 | 155.0 ± 29.6 | 141.0 ± 41.6 | 0.939 |
QRS duration, milliseconds [mean ± standard deviation] | 91.6 ± 8.6 | 90.7 ± 8.0 | 93.5 ± 10.2 | 0.567 |
Complete left bundle branch block, [n, (%)] | 0 (0) | 0 (0) | 0 (0) | Â |
Complete right bundle branch block, [n, (%)] | 0 (0) | 0 (0) | 0 (0) | Â |
Medications | Â | Â | Â | Â |
Beta-blockers [n, (%)] | 8 (29.6) | 4 (25.0) | 4 (36.4) | 0.675 |
ACE inhibitors/ARBs | 10 (37.0) | 5 (31.3) | 5 (45.5) | 0.687 |
MRA [n, (%)] | 0 (0) | 0 (0) | 0 (0) | Â |
Prior Oncologic Therapies Anthracycline cumulative dose, mg/m2 [median (IQR)] | 585.0(566.0-1019.0) | 579.0 (561.0-888.0) | 600.0 (574.0-1034.0) | 0.562 |
Previous Autologous HSCT [n, (%)] | 14 (51.9%) | 9 (56.3) | 5 (45.5) | 0.704 |
Number of Previous Chemotherapy Lines mean ± standard deviation] | 2.79 ± 1.29 | 2.94 ± 1.61 | 2.55 ± 0.69 | 0.456 |
CAR-T cell formulation | Â | Â | Â | Â |
Axicabtagene Ciloleucel [n, (%)] | 10 (37.1) | 7 (43.8) | 3 (27.3) | 0.448 |
Tisagenlecleucel [n, (%)] | 9 (33.3) | 4 (25.9) | 5 (45.4) | 0.411 |
Brexucabtagene Autoleucel [n, (%)] | 8 (29.6) | 5 (31.3) | 3 (27.3) | 1.000 |
Laboratory data | Â | Â | Â | Â |
PLT x103/L [median (IQR)] | 154.0 (97.0-186.5) | 157.0(100.5-216.3) | 137.0(95.5–157) | 0.267 |
Serum creatinine, mg/dL [mean ± standard deviation] | 0.9 ± 0.3 | 0.9 ± 0.3 | 1.0 ± 0.2 | 0.320 |
Fibrinogen, mg/dL [median (IQR)] | 387.0 (297.0-466.0) | 409.0 (296.0-556.0) | 374.0 (310.0-387.0) | 0.208 |
D-Dimer [median (IQR)] | 997.0 (754.0-1573.0) | 1078.0 (751.0-1804.0) | 997.0 (915.0-1323.0) | 0.981 |
Ferritin, ng/mL [median (IQR)] | 193.0 (129.0-479.0) | 195.0 (134.0-531.0) | 193.0 (132.0-479.0) | 0.981 |
Partial thromboplastin time, seconds [mean ± standard deviation] | 30.3 ± 4.4 | 29.7 ± 4.6 | 31.3 ± 4.2 | 0.364 |
Antithrombin-III, % [mean ± standard deviation] | 99.0 ± 11.5 | 97.5 ± 11.3 | 101.0 ± 11.9 | 0.431 |
VIII Factor, % [median (IQR)] | 193.0 (154.0-225.0) | 195.0 (157.0-223.0) | 193.0 (150.0-221.0) | 1.000 |
Von Willebrand Factor, % [median (IQR)] | 207.0 (180.0-260.0) | 207.0 (182.0-253.0) | 220.0 (177.0-284.0) | 0.827 |
Cardiac biomarkers | Â | Â | Â | Â |
hs-Troponin T, ng/mL [median (IQR)] | 5.0 (4.0–6.0) | 5.0 (3.8-5.0) | 5.0 (5.0–7.0) | 0.179 |
NT-proBNP, pg/mL [median (IQR)] | 30.5 (15.5–124.0) | 57.0 (22.0-142.0) | 16.0 (12.0-111.0) | 0.121 |
sST2, ng/mL [median (IQR)] | 27.0 (21.5–42.8) | 27.0 (18.5–36.3) | 27.0 (22.3–52.8) | 0.470 |
Inflammatory biomarkers | Â | Â | Â | Â |
Interleukin 2 receptor, UI/L [median (IQR)] | 1416.0 (1113.0-2378.0) | 1334.0 (1160.0-1930.0) | 1540.0 (1084.0-2378.0) | 0.923 |
Interleukin 6, ng/L [median (IQR)] | 23.6 (12.3–86.9) | 31.9 (11.3–155.0) | 19.6 (13.4–28.6) | 0.633 |
Echocardiographic parameters | Â | Â | Â | Â |
LVEDV, ml [mean ± standard deviation] | 94.5 ± 19.5 | 91.6 ± 21.4 | 98.6 ± 16.3 | 0.344 |
LVESV, ml [median (IQR)] | 39.0 (30.0-47.5) | 34.5 (29.0-44.5) | 40 (35.5–47.5) | 0.387 |
LV Simpson Biplane EF, % [median (IQR)] | 60.0 (56.0-61.5) | 60.0 (55.0-62.3) | 60.0 (56.5–60.0) | 0.765 |
LV GLS, % [mean ± standard deviation] | -18.2 ± 2.2 | -17.9 ± 2.6 | -18.8 ± 1.6 | 0.260 |
Medial mitral S’ velocity, cm/s [mean ± standard deviation] | 9.4 ± 1.8 | 9.1 ± 2.0 | 9.9 ± 1.4 | 0.276 |
E/A ratio [median (IQR)] | 0.8 (0.7-1.0) | 0.8 (0.7-1.0) | 0.8 (0.7–1.1) | 0.708 |
E/e’ ratio, units [median (IQR)] | 6.0 (5.0-8.5) | 5.5 (4.0–7.0) | 9.0 (6.0-10.5) | 0.011 |
LAV max, ml [mean ± standard deviation] | 47.6 ± 12.6 | 44.9 ± 12.5 | 51.4 ± 12.2 | 0.197 |
LA Reservoir Strain, % [mean ± standard deviation] | 22.3 ± 5.4 | 21.6 ± 6.3 | 23.4 ± 4.1 | 0.392 |
TAPSE, mm [median (IQR)] | 21.0 (18.0-23.5) | 20.5 (18.0–23.0) | 22.0 (20.0-24.5) | 0.485 |
S’ RV, cm/s [mean ± standard deviation] | 12.8 ± 2.4 | 12.4 ± 2.4 | 13.3 ± 2.5 | 0.398 |
Cytokine release syndrome | 24 (88,8) | 16 (100) | 8 (72.7) | 0.057 |
Cytokine Release Syndrome grade ≥ 2, [n, (%)] | 19 (70.4) | 15 (93.8) | 4 (36.4) | 0.002 |
Neurotoxicity, [n, (%)] | 10 (37.0) | 5 (31.3) | 5 (45.5) | 0.687 |
Fever, [n, (%)] | 23 (85.2) | 16 (100) | 7 (63.6) | 0.019 |
Hypotension, [n, (%)] | 14 (51.8) | 10 (62.5) | 4 (36.4) | 0.252 |
Tocilizumab Use, [n, (%)] | 19 (70.4) | 15 (93.8) | 4 (36.4) | 0.002 |
Corticosteroid Use, [n, (%)] | 10 (37.0) | 6 (37.5) | 4 (36.4) | 1.000 |