Table 1.
Penn Criteria [12] | ||||
---|---|---|---|---|
Grade 1 | Grade 2 | Grade 3 | Grade 4 | |
Mild reaction: Treated with supportive care, such as antipyretics, antiemetics | Moderate reaction: Some signs of organ dysfunction (grade 2 creatinine or grade 3 LFTs) related to CRS and not attributable to any other condition. Hospitalization for management of CRS-related symptoms, including neutropenic fever and need for i.v. therapies (not including fluid resuscitation for hypotension) | More severe reaction: Hospitalization required for management of symptoms related to organ dysfunction, including grade 4 LFTs or grade 3 creatinine, related to CRS and not attributable to any other condition. Hypotension treated with multiple fluid boluses or low-dose vasopressors. Coagulopathy requiring fresh frozen plasma, cryoprecipitate, or fibrinogen concentrate. Hypoxia requiring supplemental oxygen (nasal cannula oxygen, high-flow oxygen, CPAP, or BiPAP) | Life-threatening complications such as hypotension requiring high-dose vasopressors. Hypoxia requiring mechanical ventilation | |
Lee Criteria [13] | ||||
Grade 1 | Grade 2 | Grade 3 | Grade 4 | |
Symptoms are not life-threatening and require symptomatic treatment only (fever, nausea, fatigue, headache, myalgias, malaise) | Symptoms require and respond to moderate intervention: Oxygen requirement < 40% FiO2, OR hypotension responsive to i.v. fluids or low dose of one vasopressor, OR grade 2 organ toxicity * |
Symptoms require and respond to aggressive intervention: Oxygen requirement ≥ 40% FiO2, OR Hypotension requiring high-dose or multiple vasopressors, OR grade 3 organ toxicity, or grade 4 transaminitis |
Life-threatening symptoms: Requirement for ventilator support, OR grade 4 organ toxicity (excluding transaminitis) |
|
ASTCT Consensus Criteria [14] | ||||
Grade 1 | Grade 2 | Grade 3 | Grade 4 | |
Temperature ≥ 38 °C, no hypotension, no hypoxia | Temperature ≥ 38 °C, with hypotension not requiring vasopressors, and/or hypoxia requiring low flow nasal cannula | Temperature ≥ 38 °C, with hypotension requiring vasopressors with or without vasopressin, and/or hypoxia requiring high-flow nasal cannula, facemask, nonrebreather mask, or venturi mask | Temperature ≥ 38 °C, with hypotension requiring multiple vasopressors (excluding vasopressin), and/or hypoxia requiring positive pressure (CPAP, BiPAP, intubation, and mechanical ventilation) |
* Cardiac (tachycardia, arrhythmias, heart block, or decrease in ejection fraction), respiratory (tachypnea, pleural effusion, or pulmonary edema), renal (acute kidney injury, increase in serume creatinine level, or decrease in urine output), gastrointestinal (nausea, vomiting, or diarrhea), hepatic (increase in serum alanine aminotransferase, aspartate aminotransferase, or bilirubin level), coagulopathy (disseminated intravascular coagulation), or dermatologic (rash).