Haematology · Oncology · Neurology

ASTCT ICANS Grade (Adults) calculator

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

Clinical inputs

Immune Effector Cell Encephalopathy (ICE) score

points

Allowed range: 0–10 points

0–10. Orientation 4, naming 3, commands 1, writing 1, attention 1.

Level of consciousness

Seizure

Motor findings

Elevated intracranial pressure or cerebral edema

Result

5 fields remaining

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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: Adult ICANS grade is the worst domain. ICE 10 = 0; ICE 7–9 = 1; ICE 3–6 = 2; ICE 0–2 = 3; unarousable ICE = 4. Consciousness: awakens to voice = 2, tactile only = 3, unarousable/stupor/coma = 4. Seizure that resolves rapidly or EEG seizures that resolve with intervention = 3; prolonged (>5 min) or repetitive seizures without return to baseline = 4. Deep focal motor weakness = 4. Focal/local edema = 3; diffuse cerebral edema, decerebrate or decorticate posturing, cranial nerve VI palsy, papilledema, or Cushing triad = 4. (2019)

Scope: Adults on immune effector-cell therapy when grading ICANS. The ICE tool is the 10-point encephalopathy score from the same 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: Adult ICANS grade is the worst domain. ICE 10 = 0; ICE 7–9 = 1; ICE 3–6 = 2; ICE 0–2 = 3; unarousable ICE = 4. Consciousness: awakens to voice = 2, tactile only = 3, unarousable/stupor/coma = 4. Seizure that resolves rapidly or EEG seizures that resolve with intervention = 3; prolonged (>5 min) or repetitive seizures without return to baseline = 4. Deep focal motor weakness = 4. Focal/local edema = 3; diffuse cerebral edema, decerebrate or decorticate posturing, cranial nerve VI palsy, papilledema, or Cushing triad = 4. (2019)

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Clinical inputs

Immune Effector Cell Encephalopathy (ICE) score (points)Accepted range: 0 to 10
Level of consciousness
Seizure
Motor findings
Elevated intracranial pressure or cerebral edema

Primary source

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