The Drug-Induced Respiratory Disease Website

CAR T-cell therapy

Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)

Arrhythmias-Dysrhythmias, including atrial fibrillation (Review at PMID 15582307), ventricular tachycardia/fibrillation See also under torsades de pointe under XIIt

Publications

Goldman A, Maor E, Bomze D, Liu JE, Herrmann J, Fein J, Steingart RM, Mahmood SS, Schaffer WL, Perales MA, Shouval R

Adverse Cardiovascular and Pulmonary Events Associated With Chimeric Antigen Receptor T-Cell Therapy.

Journal of the American College of Cardiology 2021 11 02;78;1800-1813 — 2021 11 02 — 1800-1813

Burns EA, Gentille C, Trachtenberg B, Pingali SR, Anand K

Cardiotoxicity Associated with Anti-CD19 Chimeric Antigen Receptor T-Cell (CAR-T) Therapy: Recognition, Risk Factors, and Management.

Diseases (Basel, Switzerland) 2021 Mar 17;9; — 2021 Mar 17

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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