Lee et al reported a grading system for the Cytokine Release Syndrome (CRS). The authors are from National Cancer Institute, Seattle Children's Hospital, University of Pennsylvania, Texas Children's Hospital and Children's Hospital of Philadelphia.
Patient selection: cytokine release syndrome
Parameters:
(1) symptoms
(2) respiratory findings
(3) hypotension
(4) grade of organ toxicity
Symptoms
Grade
none
0
fever, nausea, fatigue, headache, myalgia, malaise (constitutional); amenable to symptomatic therapy
1
Respiratory
FIO2 < 40%
2
FIO2 >= 40%
3
ventilator support
4
Hypotension
responsive to IV fluids or low dose of one vasopressor
high dose or multiple vasopressors
Organ Toxicity
Grade 2
Grade 3 or Grade 4 elevation AST or ALT
Grade 4 except AST or ALT
Death
5
final Grade =
= MAX(Grade for all 4 parameters)
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Specialty: Immunology/Rheumatology
