Haematology · Oncology · ICU and Critical Care

ASTCT Cytokine Release Syndrome Grade calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Fever of at least 38°C not explained by another cause

Hypotension

Hypoxia

Result

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Primary source

Lee DW et al. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. Biol Blood Marrow Transplant. DOI: 10.1016/j.bbmt.2018.12.758. PMID: 30592986. Scope: Grade is the more severe of hypotension and hypoxia. Fever ≥38°C without hypotension or hypoxia is grade 1. Hypotension not requiring vasopressors, or hypoxia needing low-flow nasal cannula ≤6 L/min or blow-by, is grade 2. One vasopressor with or without vasopressin, or hypoxia needing high-flow nasal cannula, facemask, nonrebreather, or Venturi mask, is grade 3. Multiple vasopressors excluding vasopressin, or hypoxia needing positive pressure (CPAP, BiPAP, intubation and mechanical ventilation), is grade 4. No fever and no hypotension or hypoxia is not CRS (grade 0). (2019)

Scope: Children and adults on immune effector-cell therapy when grading cytokine release syndrome with the 2019 ASTCT consensus.

Last reviewed 2026-10-16

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Professional use only

For qualified clinicians. Independently verify inputs, calculations, source guidance, and applicability before any clinical action. This calculator does not replace clinical judgment.

Source: Lee DW et al. ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells. Biol Blood Marrow Transplant. DOI: 10.1016/j.bbmt.2018.12.758. PMID: 30592986. Scope: Grade is the more severe of hypotension and hypoxia. Fever ≥38°C without hypotension or hypoxia is grade 1. Hypotension not requiring vasopressors, or hypoxia needing low-flow nasal cannula ≤6 L/min or blow-by, is grade 2. One vasopressor with or without vasopressin, or hypoxia needing high-flow nasal cannula, facemask, nonrebreather, or Venturi mask, is grade 3. Multiple vasopressors excluding vasopressin, or hypoxia needing positive pressure (CPAP, BiPAP, intubation and mechanical ventilation), is grade 4. No fever and no hypotension or hypoxia is not CRS (grade 0). (2019)

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Clinical inputs

Fever of at least 38°C not explained by another cause
Hypotension
Hypoxia

Primary source

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