Hematologic malignancies carry a heightened risk of Cytokine Release Syndrome (CRS) due to cytotoxic chemotherapies and Chimeric Antigen Receptor T (CAR-T) cellular therapies. This study explores the relationship between various risk factors and CRS in patients with hematological malignancies.

Utilizing National Inpatient Sample (NIS) data from 2019 and 2020, we identified patients with hematological malignancies and a secondary diagnosis of CRS. We examined mortality, length of stay, and total treatment costs, conducting a multivariate regression analysis to assess the association of different risk factors with CRS.

A total of 200,590 patients were hospitalized with hematological malignancies, of whom 340 developed CRS. No statistically significant differences were observed in baseline demographic characteristics such as age, sex, insurance and income status, race, hospital teaching, rural, and size status. However, the odds of mortality were increased in CRS patients (OR 3.32, 95% CI 2.93-3.76, P<0.001). Total charges were significantly increased in CRS patients (+USD 654,286, 95% CI 375,835-932,636, P<0.001), but no difference was noted in length of stay between the two groups (+3.13, 95% CI 0.38-5.88, P=0.025). Fluid and electrolyte disorders (OR 2.71, 95% CI 2.47-2.97, P<0.001), obesity (OR 1.15, 95% CI 1.01-1.32, P=0.027), and heart failure (OR 1.39, 95% CI 1.2-1.6, P<0.001) demonstrated a higher risk of association with CRS. CRS patients were also more likely to have palliative care involvement (OR 1.71, 95% CI 1.52-1.92, P<0.001). Conversely, hypertension (OR 0.84, 95% CI 0.76-0.93, P=0.001) and major depressive disorder (OR 0.74, 95% CI 0.64-0.86, P<0.001) were associated with a decreased risk of CRS in hematological cancer patients.

CRS in hematological cancer patients is linked to increased mortality and hospitalization costs. Key risk factors include obesity, heart failure, and fluid and electrolyte disorders. Emphasizing holistic management of these conditions and adhering to evidence-based practices is crucial for improving patient outcomes and reducing adverse events.