F-13 | Use of Aspirin is Associated With Lower Mortality in Patients With Acute Chest Radiation

Background: Bispecific antibodies (BsAbs) are recombinant molecules containing two different antigens or epitopes.They have revolutionized the management of hematologic malignancies by demonstrating significant efficacy.Blinatumomab, the first FDA-approved BsAb, is used to treat relapsed or refractory B-cell precursor acute lymphoblastic leukemia (B-ALL) and minimal residual disease-positive B-cell ALL.Given the acuity of cardiac events that may influence patient outcomes, this meta-analysis investigates the cardiac adverse effects associated with blinatumomab.Methods: A systematic literature search was conducted to identify randomized control trials testing blinatumomab as monotherapy.Eighteen studies were included (2 Phase I, 3 Phase I/II, 10 Phase II, 1 Phase II/III, 2 Phase III).Cardiac adverse effects were analyzed.A metaanalysis was performed using the R meta package.Proportions and 95% confidence intervals (CI) were calculated for each study.A random-effects model was utilized.Heterogeneity was assessed using the I 2 statistic.Results: A total of 1063 patients were included.The significant occurrence rates were 10.4% for tachycardia (95% CI 0.6% -17.5%, p 0.01, I 2 63.3%), 7.6% for cardiac arrythmias (95% CI 1.3% -33.8%, p 0.03, I 2 62.8%), and 1.5% for atrial fibrillation (95% CI 0.2% -12.9%, p 0.03, I 2 66.7%).Other rates were 2.3% bradycardia (95% CI 0.3%-16.1%,p 0.09, I 2 53.6%), 0.6% cardiac arrest (95% CI 0% -49.0%, p 0.57, I 2 0.0%), 1.7% heart failure (95% CI 0.3% -9.7%, p 0.08, I 2 52.1), 8.1% hypertension (95% CI 5.2% -12.5%, p 0.09, I 2 43.6), 11.0% hypotension (95% CI 9.3% -13.1%, p 0.74, I 2 0.0%), and 2.0% SVT (95% CI 0% -52.6%, p 0.09, I 2 59.1%).Conclusions: BsABs, with their innovative therapeutic applications, have been used with increasing frequency for the treatment of hematologic malignancies.Among them, blinatumomab has the most well-documented adverse effect profile.As the utilization of BsAbs continues to grow, it is crucial for practicing oncologists, cardiologists, and pharmacists to remain vigilant about cardiac toxicities.This meta-analysis identified tachycardia, cardiac arrhythmias, and atrial fibrillation as the most significant cardiac adverse events.