Table 2 MD Anderson Cancer Centre CRS grading system31
From: The biological basis and clinical symptoms of CAR-T therapy-associated toxicites
Symptom or sign of CRS | CRS grade 1a | CRS grade 2a | CRS grade 3a | CRS grade 4a |
|---|---|---|---|---|
Vital signs | ||||
Temperature ≥38 °C (fever) | Yes | Any | Any | Any |
Systolic blood pressure <90 mm Hg (hypotension) | No | Responds to intravenous fluids or low-dose vasopressors | Needs high-dose or multiple vasopressors | Life-threatening |
Needing oxygen for SaO2 >90% (hypoxia) | No | FiO2 < 40% | FiO2 ≥ 40% | Needs ventilator support |
Organ toxicitiesa Cardiac: tachycardia, arrhythmias, heart block, low ejection fraction Respiratory: tachypnea, pleural effusion, pulmonary edema Gastrointestinal: nausea, vomiting, diarrhea Hepatic: increased serum ALT, AST, or bilirubin levels Renal: acute kidney injury (increased serum creatinine levels), decreased urine output Dermatological: rash (less common) Coagulopathy: disseminated intravascular coagulation (less common) | Grade 1 | Grade 2 | Grade 3 or grade 4 transaminitis | Grade 4 except grade 4 transaminitis |
