Table 5.

ASTCT ICANS Consensus Grading for Adults [148].

Neurotoxicity	Grade 1	Grade 2	Grade 3	Grade 4
ICE score	7–9	3–6	0–2	0 Patient is unarousable and unable to perform ICE
Depressed level of consciousness	Awakens spontaneously	Awakens to voice	Awakens only to tactile stimulus	Patient is unarousable or requires vigorous or repetitive tactile stimuli to arouse (stupor or coma)
Seizure	NA	NA	Any clinical seizure, focal or generalized, which resolves rapidly or nonconvulsive seizures on EEG that resolve with intervention	Life-threatening prolonged seizure (>5 min) or repetitive clinical or electrical seizures without return to baseline in between
Motor findings	NA	NA	NA	Deep focal motor weakness such as hemiparesis or paraparesis
Elevated ICP/cerebral edema	NA	NA	Focal/local edema on neuroimaging	Diffuse cerebral edema on neuroimaging; decerebrate or decorticate posturing or cranial nerve VI palsy; papilledema; or Cushing’s triad

Abbreviations: EEG, electroencephalography; ICE, immune effector cell-associated encephalopathy; ICP, intracranial pressure. Immune effector cell-associated neurotoxicity is characterized by different mainly unspecific symptoms. The ASTCT ICANS Consensus Grading for Adults evaluates neurologic symptoms and the results of neuroimaging techniques.