Abstract 3375: Demographic characteristics and incidence of cardiovascular events, infections and cytokine response syndrome (CRS) in patients treated with chimeric antigen receptor (CAR) T cell therapy: a nationwide analysis

Abstract Introduction: CAR-T cell therapy represents a significant advancement in the management of relapsed/refractory hematological malignancies. Adverse events include cytokine release syndrome (CRS), infections, and neurological and cardiovascular events. Though real-world data from referral centers regarding the uptake of CAR-T cell therapy in different populations and the incidence of various adverse events are available, we used the National Inpatient Sample (NIS) with weighted analysis to provide contemporary data representing national estimates for patients and complications profile with CAR-T therapy. Methods: A retrospective study was conducted by obtaining patients who underwent CAR-T cell therapy using ICD-10-PCS procedure codes (XW033C3, XW043C3, XW23346, XW24346, XW23376 and XW24376) from NIS 2021 dataset. Demographic characteristics, as well as the incidence of infectious complications and adverse cardiovascular events, were obtained using ICD-10-CM diagnostic codes. Different grades of CRS were identified using specific ICD-10 codes (Grade 1-5: D89.831-D89.835). Results: Of 2, 235 patients who underwent CAR-T cell therapy between January 2021 and December 2021, 64.2% were male, 73.5% identified as Caucasian, 12.3% as Asian and 5.5% as African American. 50.6% had private insurance, 36.5% had Medicare, and 6.7% had Medicaid. Most patients had lymphomas (64.9%), followed by myelomas (17.9%) and leukemias (13%). Acute myocardial infarction and stroke were documented in 0.4% of patients each. Notably, 21.7% of patients experienced cardiac arrhythmias, and major cardiovascular events were recorded in 4.3% of the cohort. Additionally, 4.9% of patients were diagnosed with pneumonia, while sepsis occurred in 7.6% of patients, and 3.4% experienced septic shock. Moreover, 1.1% of patients developed HLH. CRS was observed in 59.3% of the patients. Among those with CRS, grade 1 and grade 2 reactions were reported in 32% and 21% of patients, respectively, while grade 3 and grade 4 reactions were noted in 4.7% and 2% of patients, with no cases of grade 5 identified. The mean total cost of hospitalization was 324, 972.8 USD. The overall in-hospital mortality rate was found to be 3.4%. Conclusion: In our study, most patients were males, and the majority belonged to the Caucasian ethnicity. Over half of the patients had private insurance. CRS was common but mostly low-grade intensity. Infections present a considerable challenge with CAR-T therapy, making early identification and appropriate antimicrobial treatment critical. Adverse cardiovascular events were frequently reported among patients receiving CAR-T cell therapy, underscoring the necessity for close cardiac monitoring to detect such events and to implement comprehensive care strategies effectively. Citation Format: Himil Mahadevia, Karnav Modi, Akhil Jain, Furha Cossor, Deepthi Vodnala, Taiyeb Khumri. Demographic characteristics and incidence of cardiovascular events, infections and cytokine response syndrome (CRS) in patients treated with chimeric antigen receptor (CAR) T cell therapy: a nationwide analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3375.