cytokine_release_syndrome_grading: Cytokine Release Syndrome (CRS) Grading (ASTCT 2019)

In cliot: Clinical Indices and Outcomes Tools

Cytokine Release Syndrome (CRS) Grading (ASTCT 2019)

Description

Calculates the grade of Cytokine Release Syndrome (CRS) according to the 2019 American Society for Transplantation and Cellular Therapy (ASTCT) consensus grading system. This system is used to assess the severity of CRS in patients receiving immune effector cell therapies (e.g., CAR-T cells).

Usage

cytokine_release_syndrome_grading(temperature_c, hypotension_present,
                                  hypotension_management, hypoxia_present,
                                  hypoxia_management)

Arguments

temperature_c	Numeric. Patient temperature in degrees Celsius. Fever (>= 38.0 C) is a prerequisite for CRS diagnosis.
hypotension_present	Numeric (0 or 1). Presence of hypotension. (1 = Yes).
hypotension_management	String. Management required for hypotension. Options: "none", "fluids", "low_dose_vasopressor" (e.g., one pressor), "high_dose_vasopressor" (e.g., multiple pressors).
hypoxia_present	Numeric (0 or 1). Presence of hypoxia (SpO2 < 93% on room air). (1 = Yes).
hypoxia_management	String. Management required for hypoxia. Options: "none", "low_flow_o2" (<6L/min NC), "high_flow_o2" (>=6L/min NC, mask), "positive_pressure" (CPAP, BiPAP, Mechanical Ventilation).

Value

A list containing:

CRS_Grade	The calculated CRS Grade (0-4).
Description	The clinical definition of the assigned grade.

References

Lee DW, Santomasso BD, Locke FL, et al. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. Biol Blood Marrow Transplant. 2019;25(4):625-638. doi:10.1016/j.bbmt.2018.12.758

Examples

# Example 1: Grade 2 CRS
# Fever 38.5, Hypotension responding to fluids, No hypoxia
cytokine_release_syndrome_grading(38.5, 1, "fluids", 0, "none")

# Example 2: Grade 3 CRS
# Fever 39.0, Hypotension on Norepi, Hypoxia on High Flow O2
cytokine_release_syndrome_grading(39.0, 1, "low_dose_vasopressor", 1, "high_flow_o2")

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