Table 2.
CRS definitions across different scales.
| Scale | Grade I | Grade 2 | Grade 3 | Grade 4 | Grade 5 |
|---|---|---|---|---|---|
| MSKCC (83) | Mild symptoms requiring observation or supportive care only | • Hypotension requiring any vasopressors <24 h • Hypoxia/dyspnea requiring O2 <40% |
• Hypotension requiring any vasopressors ≥24 h • Hypoxia/dyspnea requiring O2 ≥40% |
• Hypotension refractory to high-dose vasopressors • Hypoxia/dyspnea requiring mechanical ventilation |
Death |
| Lee et al. (31) | Fever, constitutional symptoms | • Hypotension responsive to fluids or one low dose pressor • Hypoxia responsive to <40% O2 • Organ toxicity: grade 2 |
• Hypotension requiring multiple pressors or high dose pressors • Hypoxia requiring ≥40% O2 • Organ toxicity: grade 3, grade 4 transaminitis |
• Hypoxia requiring mechanical ventilation • Organ toxicity: grade 4, excluding transaminitis |
Death |
| Penn (84) | Mild reaction | • Organ toxicity: grade 2 creatinine, grade 3 transaminitis • Hospitalization for management of CRS-related symptoms |
• Organ toxicity: organ dysfunction requiring hospitalization, including grade 4 transaminitis or grade 3 creatinine • Hypotension requiring IV fluids or low-dose vasopressors • Coagulopathy requiring blood product transfusions • Hypoxia requiring supplemental oxygen |
• Hypoxia requiring mechanical ventilation • Hypotension requiring high-dose vasopressors |
Death |
| CARTOX (78) | • Temperature ≥38°C • Grade 1 organ toxicity |
• Hypotension responsive to IV fluids or low-dose vasopressors • Hypoxia requiring FiO2 <40% • Grade 2 organ toxicity |
• Hypotension needing high-dose or multiple vasopressors • Hypoxia requiring FiO2 ≥40% • Grade 3 organ toxicity or grade 4 transaminitis |
• Life-threatening hypotension needing ventilator support • Grade 4 organ toxicity except grade 4 transaminitis |
Death |
| ASTCT (85) | Fever without hypotension or hypoxia | Fever with either: • Hypotension not requiring vasopressors • Hypoxia requiring low-flow nasal cannula or blow-by |
Fever with either: • Hypotension requiring a vasopressor • Hypoxia requiring high-flow nasal cannula, facemask, non-rebreather mask, or Venturi mask |
Fever with either: • Hypotension requiring multiple vasopressors (excluding vasopressin) • Hypoxia requiring positive pressure ventilation |
Death |
| CTCAE5.0 (86) | Fever with or without constitutional symptoms | Hypotension responding to fluids; hypoxia responding to <40% O2 | Hypotension managed with one pressor; hypoxia requiring ≥ 40% O2 | Life-threatening consequences; urgent intervention indicated | Death |