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989 Clinical Tools

4Ts Score (HIT)aaIPI (Age-adjusted IPI)ABC Score (Massive Transfusion)Absolute Neutrophil Count Age-adjusted D-dimer Threshold aGvHD Grading (Glucksberg/MAGIC)AL Amyloidosis Staging (Mayo)Anti-Xa Monitoring Interpreter Antiphospholipid Syndrome Classification Binet / Rai Staging (CML)Blood Volume Calculator Caprini VTE Risk Score CISNE Score CLL-IPI Coombs-Negative Haemolysis Checklist Corrected Reticulocyte Count CRS Grading (ASTCT 2019)DAT Interpretation Algorithm Deauville Score Interpreter DIC Score (ISTH)DIPSS (MF)DIPSS-Plus (MF)DOAC Dose Selector DOAC Renal Dose Adjustment DRI (Disease Risk Index)Durie-Salmon Staging (historical)EBMT Risk Score ELN 2022 AML Risk Classification ELTS Score (CML)England & Fraser Index EUTOS Score (CML)Expected Hb Rise per RBC Unit Factor Inhibitor Bethesda Titre Interpreter Febrile Neutropaenia Risk (MASCC)Fibrinogen Replacement FLIPI (Follicular Lymphoma IPI)FLIPI-2 French TTP Score GAPSS (Global APS Score)Haemophilia Severity Classification HbS Percentage Target Calculator HCT-CI (Comorbidity Index)HEP Score Heparin Nomogram (Weight-based)Hepatic Iron Index HERDOO2 Rule HFE Haemochromatosis Risk Estimator ICANS Grading (ASTCT 2019)IMWG Response Criteria (Myeloma)IPI (International Prognostic Index)IPSID / Lugano Classification IPSS-M (Molecular IPSS)IPSS-R (Revised IPSS for MDS)Iron Deficit Calculator (Ganzoni Formula)ISS (Myeloma)ISTH Bleeding Assessment Tool (BAT)ISTH Non-Overt DIC Score ITP Bleeding Score iwCLL Response Criteria (2018)IWG ITP Response Criteria JAK2V617F Allele Burden Interpreter Karnofsky Performance Scale Leucostasis Risk Threshold Lupus Anticoagulant (LAC) Reporting Framework MAGIC aGvHD Biomarker Score MCV-based Anaemia Algorithm Mentzer Index MIPI (MCL IPI)MIPSS70+ v2.0 (MF)Mixing Study Interpretation MRD Assessment Threshold Interpreter mSMART 3.0 (Myeloma)MTP Activation Criteria NCCN-IPI NIH Chronic GvHD Scoring NTDT Iron Burden Estimator Padua RAM PBT (Paediatric BAT)PCNSL MSKCC Score PERC Rule Perioperative Anticoagulation Bridging PESI Score (PE Mortality)PLASMIC Score Platelet Increment Calculator (CCI)PNH Clone Size Interpreter R-IPI (Revised IPI)R-ISS (Revised ISS)Reticulocyte Index (RPI)Revised Geneva Score (PE)Revised Response Criteria (NHL)Revised Zubrod / ECOG Performance Shine & Lal Index Sickle Cell Disease Risk (TCD)SLiM-CRAB Criteria SOKAL Score (CML)Sokal/EUTOS/ELTS Comparison sPESI (Simplified PESI)TACO Risk Score Thalassaemia Transfusion Threshold Thrombocytopaenia Differential Thrombophilia Screening Eligibility Algorithm Time in Therapeutic Range (TTR)TLS Risk Classification Transferrin Saturation Calculator Vienna Prediction Model von Willebrand Factor Activity Interpreter Warfarin Dose Calculator Wells Score (DVT)Wells Score (PE)WHO 2022 AML Classification Mapper WHO Bleeding Scale YEARS Algorithm

CRS Grading (ASTCT 2019)

ASTCT Consensus Grading: Standardized criteria for Cytokine Release Syndrome. Grade is dictated by the highest severity level reached in any category (Fever, Hypotension, Hypoxia).

1. Temperature

2. Hypotension

3. Hypoxia

ASTCT 2019 CRS Grade

-

Patient does not meet the ASTCT 2019 criteria for CRS (Fever is mandatory).

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Grading the severity of Cytokine Release Syndrome (CRS) following immune effector cell (IEC) therapy (e.g., CAR-T).

To guide clinical management, including the initiation of tocilizumab and corticosteroids.

Standardizing toxicity reporting across clinical trials and institutional protocols.

Patient Population

Adult and pediatric patients receiving CAR-T cells, bispecific antibodies (BiTEs), or other immune effector cell therapies.

When Not to Rely on This Score Alone

Sepsis or septic shock — must exclude infection as the primary cause of fever and hypotension.

Tumor Lysis Syndrome (TLS) — although frequently co-occurring, TLS has separate management and grading.

Neurotoxicity (ICANS) — requires separate assessment using the ICE score and ASTCT ICANS grading.

Section 2

Formula & Logic

Grading Logic

CRS grade is determined by the most severe symptom among fever, hypotension, and hypoxia. A fever (≥ 38.0°C) is required for the diagnosis of CRS.

ASTCT 2019 Grading Schema

Grade	Fever	Hypotension	Hypoxia
1	≥ 38°C	None	None
2	≥ 38°C	Not requiring vasopressors	Low-flow O2 (< 6 L/min)
3	≥ 38°C	One vasopressor (± vasopressin)	High-flow O2 (≥ 6 L/min)
4	≥ 38°C	Multiple vasopressors	Positive pressure (CPAP, BiPAP, Intubation)

Section 3

Pearls/Pitfalls

The Fever Requirement

A fever is mandatory for Grade 1. In higher grades, the fever may be masked by antipyretics or steroids, but the grading still applies if the symptoms were initiated by a fever.

Management Triggers

Grade 1: Symptomatic treatment; consider tocilizumab if persistent or in high-risk patients.

Grade 2: Tocilizumab (± steroids).

Grade 3/4: Aggressive management with tocilizumab AND high-dose corticosteroids.

Section 4

Evidence Appraisal

Primary Scale

ASTCT Consensus Grading for Cytokine Release Syndrome and Immune Effector Cell-Associated Neurotoxicity Syndrome in Adult and Pediatric Patients.

Lee DW et al. • Biology of Blood and Marrow Transplantation. 2019;25(4):625-638.

View Source

Section 5

Literature

Historical Context

Before 2019, multiple grading systems existed (Penn, Lee, MSKCC). The ASTCT 2019 consensus was developed to harmonize definitions across leukemia, lymphoma, and myeloma trials, focusing on objective bedside parameters (hypotension and hypoxia).

Last Comprehensive Review: 2026

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Grading the severity of Cytokine Release Syndrome (CRS) following immune effector cell (IEC) therapy (e.g., CAR-T).

To guide clinical management, including the initiation of tocilizumab and corticosteroids.

Standardizing toxicity reporting across clinical trials and institutional protocols.

Patient Population

Adult and pediatric patients receiving CAR-T cells, bispecific antibodies (BiTEs), or other immune effector cell therapies.

When Not to Rely on This Score Alone

Sepsis or septic shock — must exclude infection as the primary cause of fever and hypotension.

Tumor Lysis Syndrome (TLS) — although frequently co-occurring, TLS has separate management and grading.

Neurotoxicity (ICANS) — requires separate assessment using the ICE score and ASTCT ICANS grading.

Section 2

Formula & Logic

Grading Logic

CRS grade is determined by the most severe symptom among fever, hypotension, and hypoxia. A fever (≥ 38.0°C) is required for the diagnosis of CRS.

ASTCT 2019 Grading Schema

Grade	Fever	Hypotension	Hypoxia
1	≥ 38°C	None	None
2	≥ 38°C	Not requiring vasopressors	Low-flow O2 (< 6 L/min)
3	≥ 38°C	One vasopressor (± vasopressin)	High-flow O2 (≥ 6 L/min)
4	≥ 38°C	Multiple vasopressors	Positive pressure (CPAP, BiPAP, Intubation)

Section 3

Pearls/Pitfalls

The Fever Requirement

A fever is mandatory for Grade 1. In higher grades, the fever may be masked by antipyretics or steroids, but the grading still applies if the symptoms were initiated by a fever.

Management Triggers

Grade 1: Symptomatic treatment; consider tocilizumab if persistent or in high-risk patients.

Grade 2: Tocilizumab (± steroids).

Grade 3/4: Aggressive management with tocilizumab AND high-dose corticosteroids.

Section 4

Evidence Appraisal

Primary Scale

ASTCT Consensus Grading for Cytokine Release Syndrome and Immune Effector Cell-Associated Neurotoxicity Syndrome in Adult and Pediatric Patients.

Lee DW et al. • Biology of Blood and Marrow Transplantation. 2019;25(4):625-638.

View Source

Section 5

Literature

Historical Context

Last Comprehensive Review: 2026

Related Hematology Tools

iwCLL Response Criteria

Revised Response Criteria

PCNSL MSKCC Score

ISS

R-ISS

IMWG Response Criteria

MRD Assessment Threshold Interpreter

mSMART 3.0

SLiM-CRAB Criteria

Durie-Salmon Staging

Have feedback about this calculator?Let us know.

CRS Grading (ASTCT 2019)

ASTCT Consensus Grading: Standardized criteria for Cytokine Release Syndrome. Grade is dictated by the highest severity level reached in any category (Fever, Hypotension, Hypoxia).

1. Temperature

2. Hypotension

3. Hypoxia

ASTCT 2019 CRS Grade

-

Patient does not meet the ASTCT 2019 criteria for CRS (Fever is mandatory).

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Grading the severity of Cytokine Release Syndrome (CRS) following immune effector cell (IEC) therapy (e.g., CAR-T).

To guide clinical management, including the initiation of tocilizumab and corticosteroids.

Standardizing toxicity reporting across clinical trials and institutional protocols.

Patient Population

Adult and pediatric patients receiving CAR-T cells, bispecific antibodies (BiTEs), or other immune effector cell therapies.

When Not to Rely on This Score Alone

Sepsis or septic shock — must exclude infection as the primary cause of fever and hypotension.

Tumor Lysis Syndrome (TLS) — although frequently co-occurring, TLS has separate management and grading.

Neurotoxicity (ICANS) — requires separate assessment using the ICE score and ASTCT ICANS grading.

Section 2

Formula & Logic

Grading Logic

CRS grade is determined by the most severe symptom among fever, hypotension, and hypoxia. A fever (≥ 38.0°C) is required for the diagnosis of CRS.

ASTCT 2019 Grading Schema

Grade	Fever	Hypotension	Hypoxia
1	≥ 38°C	None	None
2	≥ 38°C	Not requiring vasopressors	Low-flow O2 (< 6 L/min)
3	≥ 38°C	One vasopressor (± vasopressin)	High-flow O2 (≥ 6 L/min)
4	≥ 38°C	Multiple vasopressors	Positive pressure (CPAP, BiPAP, Intubation)

Section 3

Pearls/Pitfalls

The Fever Requirement

A fever is mandatory for Grade 1. In higher grades, the fever may be masked by antipyretics or steroids, but the grading still applies if the symptoms were initiated by a fever.

Management Triggers

Grade 1: Symptomatic treatment; consider tocilizumab if persistent or in high-risk patients.

Grade 2: Tocilizumab (± steroids).

Grade 3/4: Aggressive management with tocilizumab AND high-dose corticosteroids.

Section 4

Evidence Appraisal

Primary Scale

ASTCT Consensus Grading for Cytokine Release Syndrome and Immune Effector Cell-Associated Neurotoxicity Syndrome in Adult and Pediatric Patients.

Lee DW et al. • Biology of Blood and Marrow Transplantation. 2019;25(4):625-638.

View Source

Section 5

Literature

Historical Context

Last Comprehensive Review: 2026

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Grading the severity of Cytokine Release Syndrome (CRS) following immune effector cell (IEC) therapy (e.g., CAR-T).

To guide clinical management, including the initiation of tocilizumab and corticosteroids.

Standardizing toxicity reporting across clinical trials and institutional protocols.

Patient Population

Adult and pediatric patients receiving CAR-T cells, bispecific antibodies (BiTEs), or other immune effector cell therapies.

When Not to Rely on This Score Alone

Sepsis or septic shock — must exclude infection as the primary cause of fever and hypotension.

Tumor Lysis Syndrome (TLS) — although frequently co-occurring, TLS has separate management and grading.

Neurotoxicity (ICANS) — requires separate assessment using the ICE score and ASTCT ICANS grading.

Section 2

Formula & Logic

Grading Logic

CRS grade is determined by the most severe symptom among fever, hypotension, and hypoxia. A fever (≥ 38.0°C) is required for the diagnosis of CRS.

ASTCT 2019 Grading Schema

Grade	Fever	Hypotension	Hypoxia
1	≥ 38°C	None	None
2	≥ 38°C	Not requiring vasopressors	Low-flow O2 (< 6 L/min)
3	≥ 38°C	One vasopressor (± vasopressin)	High-flow O2 (≥ 6 L/min)
4	≥ 38°C	Multiple vasopressors	Positive pressure (CPAP, BiPAP, Intubation)

Section 3

Pearls/Pitfalls

The Fever Requirement

A fever is mandatory for Grade 1. In higher grades, the fever may be masked by antipyretics or steroids, but the grading still applies if the symptoms were initiated by a fever.

Management Triggers

Grade 1: Symptomatic treatment; consider tocilizumab if persistent or in high-risk patients.

Grade 2: Tocilizumab (± steroids).

Grade 3/4: Aggressive management with tocilizumab AND high-dose corticosteroids.

Section 4

Evidence Appraisal

Primary Scale

ASTCT Consensus Grading for Cytokine Release Syndrome and Immune Effector Cell-Associated Neurotoxicity Syndrome in Adult and Pediatric Patients.

Lee DW et al. • Biology of Blood and Marrow Transplantation. 2019;25(4):625-638.

View Source

Section 5

Literature

Historical Context

Last Comprehensive Review: 2026

Related Hematology Tools

iwCLL Response Criteria

Revised Response Criteria

PCNSL MSKCC Score

ISS

R-ISS

IMWG Response Criteria

MRD Assessment Threshold Interpreter

mSMART 3.0

SLiM-CRAB Criteria

Durie-Salmon Staging

Have feedback about this calculator?Let us know.