🧬 ASTCT CRS Grading (CAR-T / Immunotherapy)
UseWhen to use: fever after CAR-T/bispecifics attributed to CRS.
StrataHigher grade → tocilizumab/steroids/ICU per product protocol.
LimitsWhen not to use: without fever attributed to CRS. · Pitfall: missing concurrent ICANS. · Follow product-specific toxicity SOPs.
SourceLee DW et al. Biol Blood Marrow Transplant 2019 (ASTCT CRS)
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
Fever gate.
When to use
When to use: fever after CAR-T/bispecifics attributed to CRS.
How it works
Fever required; grade = max severity from hypotension and hypoxia tiers (1–4).
Key points
- Fever gate.
- Hypotension/hypoxia drive grade.
- Next: ICE / ASTCT ICANS.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Fever ≥ 38.0 °C attributed to CRS | No |
|---|---|
| Hypotension | Present — fluids only / no vasopressors |
| Hypoxia / oxygen need | Low-flow nasal cannula (≤6 L/min) / FiO₂ <40% |
→CRS gradeNot CRS by fever criterion
- Note：ASTCT CRS requires fever ≥38 °C attributed to CRS
| Fever ≥ 38.0 °C attributed to CRS | Yes |
|---|---|
| Hypotension | Requires multiple vasopressors or high-dose vasopressors |
| Hypoxia / oxygen need | Positive pressure (CPAP/BiPAP) or mechanical ventilation |
→CRS grade4/4
- Cue：Life-threatening — ICU, advanced support, protocol steroids/anti-IL6
- Drivers：Hypotension tier 3 · Hypoxia tier 3
Verification & sources · governance
FAQ
Frequently asked questions
- Does ASTCT CRS Grading (CAR-T / Immunotherapy) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is ASTCT CRS Grading (CAR-T / Immunotherapy) calculated in practice? Can you show a worked example?
- Inputs: Fever ≥ 38.0 °C attributed to CRS No, Hypotension Present — fluids only / no vasopressors, Hypoxia / oxygen need Low-flow nasal cannula (≤6 L/min) / FiO₂ <40% → Result: CRS grade Not CRS by fever criterion（Note: ASTCT CRS requires fever ≥38 °C attributed to CRS） Inputs: Fever ≥ 38.0 °C attributed to CRS Yes, Hypotension Requires multiple vasopressors or high-dose vasopressors, Hypoxia / oxygen need Positive pressure (CPAP/BiPAP) or mechanical ventilation → Result: CRS grade 4 /4（Cue: Life-threatening — ICU, advanced support, protocol steroids/anti-IL6, Drivers: Hypotension tier 3 · Hypoxia tier 3）