Porter et al reported criteria for the cytokine release syndrome (CRS) associated with CAR T-cell therapy. The authors are from the University of Pennsylvania.
Parameters:
(1) severity of the reaction
(2) organ dysfunction
(3) hospitalization
(4) hypotension
(5) hypoxia
Severity
Organ Dysfunction
Hospitalize
Hypotension
Hypoxia
Grade
mild
no
no
no
no
1
moderate
moderate
NA
NA
no
2
moderate
NA
yes
NA
no
2
moderate
NA
yes
fluid resusc
no
2
severe
severe
yes
NA
NA
3
severe
NA
yes
low dose
NA
3
severe
NA
yes
NA
suppl O2
3
life threaten
severe
yes
high dose
NA
4
life threaten
severe
yes
NA
mech vent
4
Organ dysfunction:
(1) for grade 2: creatinine grade 2 or liver function tests grade 3
(2) for grade 3: creatinine grade 3 or liver function tests grade 4 or coagulopathy
Hypotension:
(1) for grade 2: fluid resuscitation
(2) for grade 3: low-dose vasopressors
(3) for grade 4: high-dose vasopressors
The diagnosis requires exclusion of an alternative explanation for the clinical findings.
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