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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
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    Patent Pending

    Cytokine Release Syndrome (CRS) Grading

    Assesses severity of CRS in patients on immunotherapy.

    INSTRUCTIONS

    Use in patients receiving immunotherapy for cancer.

    When to Use
    Pearls/Pitfalls
    Why Use

    Patients receiving immunotherapy for cancer with signs of cytokine-mediated immunological reactions and multi-organ dysfunction.

    • Do not forget coagulopathy as organ dysfunction.

    • High-dose vasopressors need to be on board for ≥3 hours in order to be assigned grade 3.

    • Consider corticosteroids at 24 hours if no improvement.

    • Most patients receiving immunological therapies have complicated ongoing processes and require specialized care. Clinical expertise, vigilance, and frequent follow-up are key to recognizing CRS and not attributing signs and symptoms to an alternate cause (e.g. infection).

    Helps guide interventions for patients receiving immunological therapies for cancer.

    Symptoms not life-threatening; only symptomatic treatment required (fever, nausea, fatigue, headache, myalgias, malaise)
    Moderate intervention required for response: oxygen requirement <40%, hypotension responsive to fluids, low dose of one pressor, or grade 2 organ toxicity
    Aggressive intervention required for response: oxygen requirement ≥40%, hypotension requiring high dose/multiple pressors, grade 3 organ toxicity, or grade 4 transaminitis
    Life-threatening symptoms: ventilator required, or grade 4 organ toxicity (excluding transaminitis)
    Death

    Result:

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    Next Steps
    Evidence
    Content Contributors
    • Joseph Maakaron, MD
    Content Contributors
    • Joseph Maakaron, MD