Table 3.

Grading of CAR T-Cell-Related Encephalopathy Syndrome (CRES)

Symptom or Sign	Grade 1	Grade 2	Grade 3	Grade 4
Neurological assessment score (by CARTOX-10*)	7–9 (mild impairment)	3–6 (moderate impairment)	0–2 (severe impairment)	Patient in critical condition, and/or obtunded and cannot perform assessment of tasks
Raised intracranial pressure	N/A	N/A	Stage 1–2 papilledema**, or CSF opening pressure <20mmHg	Stage 3–5 papilledema**, or CSF opening pressure ≥20mmHg, or cerebral edema
Seizures or motor weakness	N/A	N/A	Partial seizure, or non-convulsive seizures on EEG with response to BZD	Generalized seizures, or convulsive or non-convulsive status epilepticus, or new motor weakness

Notes: Data from reference.⁸ *As noted on Table 2; **Papilledema grading according to modified Frisén scale.¹²

Abbreviations: CAR, chimeric antigen receptor; CARTOX-10, CAR-T-cell-therapy-associated toxicity 10-point neurological assessment; N/A, non-applicable; CSF, cerebrospinal fluid; EEG, electroencephalogram; BZD, benzodiazepine.