Single-center retrospective cohort study of cytokine storms in COVID-19, hemophagocytic lymphohistiocytosis, and CAR-T therapy

Cytokine storm (CS) is a hyperinflammatory syndrome causing multiorgan dysfunction and high mortality, especially in patients with malignant hematologic neoplasms. Triggers include malignant neoplasm-associated hemophagocytic lymphohistiocytosis (MN-HLH), cytokine release syndrome from CAR T-cell therapy (CAR-T CRS), and COVID-19. A retrospective cohort study at MD Anderson Cancer Center (Houston, TX) delineated the inflammatory patterns characterizing different CS etiologies and their association with clinical outcomes. This study of 671 patients with malignant hematologic neoplasms identified distinct inflammatory patterns and survival outcomes between the 3 cohorts with CS. Clustering analysis revealed overlapping patterns between COVID-CS and CAR-T CRS, while MN-HLH formed a separate cluster. The authors conclude that understanding the unique and shared features of CS etiologies may inform personalized treatment strategies, highlighting the importance of early diagnosis and targeted interventions for improving patient outcomes.