Hematology · LIVE

ASTCT consensus CRS grading

ASTCT CRS

Apply Lee 2019 ASTCT Table 1 cytokine release syndrome grading and return grade 0–4 from caller-assigned fever, fever waiver, hypotension, and hypoxia. Grade is the more severe of hypotension versus hypoxia. Organ toxicities do not influence grade. Not ICANS.

LIVE $0.005 USDC GET /api/calc/astct_crs

Markdown: /docs/astct-crs.md · Canonical: https://magentlab.com/docs/astct-crs

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Apply Lee 2019 ASTCT Table 1 cytokine release syndrome grading and return grade 0–4 from caller-assigned fever, fever waiver, hypotension, and hypoxia. Grade is the more severe of hypotension versus hypoxia. Organ toxicities do not influence grade. Not ICANS.

When to use

When an agent already has caller-assigned ASTCT CRS fever, hypotension, and hypoxia tokens and needs the published Table 1 grade. magent does not measure temperature, start vasopressors, or grade ICANS.

When not to use

• Not a medical device and not a CRS diagnosis or a treatment, vasopressor, oxygen, or intubation order.
• magent does not measure temperature or start vasopressors. fever, fever_waived, hypotension, and hypoxia are caller-assigned Lee 2019 Table 1 tokens.
• Organ toxicities associated with CRS may be graded separately (for example CTCAE) but they do not influence ASTCT CRS grade.
• Not ICANS. This tool does not grade neurologic toxicity associated with immune effector cells.
• Grade 5 (death) is not returned. Both hypotension and hypoxia none without fever and without fever_waived is grade 0 (crs false), which is not a Table 1 row. Not Lee 2014.

Formula

Lee 2019 ASTCT CRS Table 1. fever is temperature ≥38°C not attributable to another cause. fever_waived true if CRS already treated with antipyretic/tocilizumab/steroids so fever is no longer required. hypotension none | no_vasopressors | one_vasopressor (with or without vasopressin) | multiple_vasopressors (excluding vasopressin). hypoxia none | low_flow (≤6 L/min nasal cannula or blow-by) | high_flow (>6 L/min, facemask, NRB, or Venturi) | positive_pressure (CPAP/BiPAP/intubation). Grade is the more severe of hypotension vs hypoxia: both none → 1 if fever or fever_waived else 0 (crs false); no_vasopressors or low_flow → 2; one_vasopressor or high_flow → 3; multiple_vasopressors or positive_pressure → 4. Organ toxicities do not influence grade. Not ICANS

Citation

Title

ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells

Authors

Lee DW, Santomasso BD, Locke FL, Ghobadi A, Turtle CJ, Brudno JN, Maus MV, Park JH, Mead E, Pavletic S, Go WY, Eldjerou L, Gardner RA, Frey N, Curran KJ, Peggs K, Pasquini M, DiPersio JF, van den Brink MRM, Komanduri KV, Grupp SA, Neelapu SS

Source

Biol Blood Marrow Transplant. 2019;25(4):625-638

DOI

10.1016/j.bbmt.2018.12.758

Worked example

Also searched as

• ASTCT CRS grading
• cytokine release syndrome
• Lee 2019 CRS
• CAR T CRS grade
• ASTCT consensus grading
• immune effector cell CRS
• fever hypotension hypoxia CRS
• not ICANS

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/astct_crs?fever=true&fever_waived=false&hypotension=none&hypoxia=none

Full URL: https://api.magentlab.com/api/calc/astct_crs?fever=true&fever_waived=false&hypotension=none&hypoxia=none

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/astct_crs?fever=true&fever_waived=false&hypotension=none&hypoxia=none"

Parameters

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/astct_crs Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

• 1 to 25 items. Each item uses the same keys as the GET query parameters.
• POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
• The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
• HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
• Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
• x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "fever": "true",
      "fever_waived": "false",
      "hypotension": "none",
      "hypoxia": "none"
    },
    {
      "fever": "true",
      "fever_waived": "false",
      "hypotension": "none",
      "hypoxia": "none"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/astct_crs",
  "items": [
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Lee DW, Santomasso BD, Locke FL, Ghobadi A, Turtle CJ, Brudno JN, Maus MV, Park JH, Mead E, Pavletic S, Go WY, Eldjerou L, Gardner RA, Frey N, Curran KJ, Peggs K, Pasquini M, DiPersio JF, van den Brink MRM, Komanduri KV, Grupp SA, Neelapu SS",
        "doi": "10.1016/j.bbmt.2018.12.758",
        "id": "lee-2019",
        "pmid": "30592986",
        "source": "Biol Blood Marrow Transplant. 2019;25(4):625-638",
        "title": "ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells"
      },
      "formula": "astct_crs",
      "formula_expression": "Lee 2019 ASTCT CRS Table 1. fever is temperature ≥38°C not attributable to another cause. fever_waived true if CRS already treated with antipyretic/tocilizumab/steroids so fever is no longer required. hypotension none | no_vasopressors | one_vasopressor (with or without vasopressin) | multiple_vasopressors (excluding vasopressin). hypoxia none | low_flow (≤6 L/min nasal cannula or blow-by) | high_flow (>6 L/min, facemask, NRB, or Venturi) | positive_pressure (CPAP/BiPAP/intubation). Grade is the more severe of hypotension vs hypoxia: both none → 1 if fever or fever_waived else 0 (crs false); no_vasopressors or low_flow → 2; one_vasopressor or high_flow → 3; multiple_vasopressors or positive_pressure → 4. Organ toxicities do not influence grade. Not ICANS",
      "criteria": [
        {
          "factor": "fever_or_waived",
          "met": true
        },
        {
          "value": "none",
          "factor": "hypotension_none",
          "met": true
        },
        {
          "factor": "hypotension_no_vasopressors",
          "met": false
        },
        {
          "factor": "hypotension_one_vasopressor",
          "met": false
        },
        {
          "factor": "hypotension_multiple_vasopressors",
          "met": false
        },
        {
          "value": "none",
          "factor": "hypoxia_none",
          "met": true
        },
        {
          "factor": "hypoxia_low_flow",
          "met": false
        },
        {
          "factor": "hypoxia_high_flow",
          "met": false
        },
        {
          "factor": "hypoxia_positive_pressure",
          "met": false
        }
      ],
      "grade": 1,
      "crs": true,
      "fever": true,
      "fever_waived": false,
      "hypotension": "none",
      "hypotension_grade": 0,
      "hypoxia": "none",
      "hypoxia_grade": 0
    },
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Lee DW, Santomasso BD, Locke FL, Ghobadi A, Turtle CJ, Brudno JN, Maus MV, Park JH, Mead E, Pavletic S, Go WY, Eldjerou L, Gardner RA, Frey N, Curran KJ, Peggs K, Pasquini M, DiPersio JF, van den Brink MRM, Komanduri KV, Grupp SA, Neelapu SS",
        "doi": "10.1016/j.bbmt.2018.12.758",
        "id": "lee-2019",
        "pmid": "30592986",
        "source": "Biol Blood Marrow Transplant. 2019;25(4):625-638",
        "title": "ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells"
      },
      "formula": "astct_crs",
      "formula_expression": "Lee 2019 ASTCT CRS Table 1. fever is temperature ≥38°C not attributable to another cause. fever_waived true if CRS already treated with antipyretic/tocilizumab/steroids so fever is no longer required. hypotension none | no_vasopressors | one_vasopressor (with or without vasopressin) | multiple_vasopressors (excluding vasopressin). hypoxia none | low_flow (≤6 L/min nasal cannula or blow-by) | high_flow (>6 L/min, facemask, NRB, or Venturi) | positive_pressure (CPAP/BiPAP/intubation). Grade is the more severe of hypotension vs hypoxia: both none → 1 if fever or fever_waived else 0 (crs false); no_vasopressors or low_flow → 2; one_vasopressor or high_flow → 3; multiple_vasopressors or positive_pressure → 4. Organ toxicities do not influence grade. Not ICANS",
      "criteria": [
        {
          "factor": "fever_or_waived",
          "met": true
        },
        {
          "value": "none",
          "factor": "hypotension_none",
          "met": true
        },
        {
          "factor": "hypotension_no_vasopressors",
          "met": false
        },
        {
          "factor": "hypotension_one_vasopressor",
          "met": false
        },
        {
          "factor": "hypotension_multiple_vasopressors",
          "met": false
        },
        {
          "value": "none",
          "factor": "hypoxia_none",
          "met": true
        },
        {
          "factor": "hypoxia_low_flow",
          "met": false
        },
        {
          "factor": "hypoxia_high_flow",
          "met": false
        },
        {
          "factor": "hypoxia_positive_pressure",
          "met": false
        }
      ],
      "grade": 1,
      "crs": true,
      "fever": true,
      "fever_waived": false,
      "hypotension": "none",
      "hypotension_grade": 0,
      "hypoxia": "none",
      "hypoxia_grade": 0
    }
  ]
}

Response

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Lee DW, Santomasso BD, Locke FL, Ghobadi A, Turtle CJ, Brudno JN, Maus MV, Park JH, Mead E, Pavletic S, Go WY, Eldjerou L, Gardner RA, Frey N, Curran KJ, Peggs K, Pasquini M, DiPersio JF, van den Brink MRM, Komanduri KV, Grupp SA, Neelapu SS",
    "doi": "10.1016/j.bbmt.2018.12.758",
    "id": "lee-2019",
    "pmid": "30592986",
    "source": "Biol Blood Marrow Transplant. 2019;25(4):625-638",
    "title": "ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells"
  },
  "formula": "astct_crs",
  "formula_expression": "Lee 2019 ASTCT CRS Table 1. fever is temperature ≥38°C not attributable to another cause. fever_waived true if CRS already treated with antipyretic/tocilizumab/steroids so fever is no longer required. hypotension none | no_vasopressors | one_vasopressor (with or without vasopressin) | multiple_vasopressors (excluding vasopressin). hypoxia none | low_flow (≤6 L/min nasal cannula or blow-by) | high_flow (>6 L/min, facemask, NRB, or Venturi) | positive_pressure (CPAP/BiPAP/intubation). Grade is the more severe of hypotension vs hypoxia: both none → 1 if fever or fever_waived else 0 (crs false); no_vasopressors or low_flow → 2; one_vasopressor or high_flow → 3; multiple_vasopressors or positive_pressure → 4. Organ toxicities do not influence grade. Not ICANS",
  "criteria": [
    {
      "factor": "fever_or_waived",
      "met": true
    },
    {
      "value": "none",
      "factor": "hypotension_none",
      "met": true
    },
    {
      "factor": "hypotension_no_vasopressors",
      "met": false
    },
    {
      "factor": "hypotension_one_vasopressor",
      "met": false
    },
    {
      "factor": "hypotension_multiple_vasopressors",
      "met": false
    },
    {
      "value": "none",
      "factor": "hypoxia_none",
      "met": true
    },
    {
      "factor": "hypoxia_low_flow",
      "met": false
    },
    {
      "factor": "hypoxia_high_flow",
      "met": false
    },
    {
      "factor": "hypoxia_positive_pressure",
      "met": false
    }
  ],
  "grade": 1,
  "crs": true,
  "fever": true,
  "fever_waived": false,
  "hypotension": "none",
  "hypotension_grade": 0,
  "hypoxia": "none",
  "hypoxia_grade": 0
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

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Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

• HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
• exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
• HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
• Execution is timeout-bounded and concurrency-capped.
• Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.