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.
Specialty: Immunology/Rheumatology