Cytokine Release Syndrome Grading System Lee
Lee et al reported a grading system for the Cytokine Release Syndrome (CRS). The authors are from the National Cancer Institute, Seattle Children's Hospital, University of Pennsylvania, Texas Children's Hospital and Children's Hospital of Philadelphia.
References (Knowledge Source)Description
Lee DW, Gardner R, et al. Current concepts in the diagnosis and management of cytokine release syndrome. Blood. 2014; 124: 188-193.
Riegler LL, Jones GP, Lee DW. Current approaches in the grading and management of cytokine release syndrome after chimeric antigen receptor T-cell therapy. Therapeutics and Risk Management. 2019; 15: 323-335.
Attachment
Grade of the Cytokine Release Syndrome (Decision)Description
Grades range from 0 (asymptomatic) to 5 (death).
Decision Logic (Decision Table)
Grade of the Cytokine Release Syndrome |
C> | Flu-like symptoms | Hypoxia | Hypotension | Organ Toxicity | Grade of the Cytokine Release Syndrome | Description | |
"None", "With FIO2 less than 40%", "With FIO2 40% or more", "Requires ventilator support" | "None", "Responsive to IV fluids", "Responsive to a low dose of one vasopressor", "Requires multiple or high dose vasopressor therapy" | "None", "Grade 2", "Grade 3", "Grade 4 elevation of AST or ALT", "Grade 4 other", "Death" | |||||
1 | false | - | - | - | 0 | ||
2 | true | - | - | - | 1 | ||
3 | - | "None" | - | - | 0 | ||
4 | - | "With FIO2 less than 40%" | - | - | 2 | ||
5 | - | "With FIO2 40% or more" | - | - | 3 | ||
6 | - | "Requires ventilator support" | - | - | 4 | ||
7 | - | - | "None" | - | 0 | ||
8 | - | - | "Responsive to IV fluids" | - | 2 | ||
9 | - | - | "Responsive to a low dose of one vasopressor" | - | 2 | ||
10 | - | - | "Requires multiple or high dose vasopressor therapy" | - | 3 | ||
11 | - | - | - | "None" | 0 | ||
12 | - | - | - | "Grade 2" | 2 | ||
13 | - | - | - | "Grade 3" | 3 | ||
14 | - | - | - | "Grade 4 elevation of AST or ALT" | 3 | ||
15 | - | - | - | "Grade 4 other" | 4 | ||
16 | - | - | - | "Death" | 5 | ||
Flu-like symptoms (Input Data)