Hematology · LIVE

ASTCT ICANS consensus grade (adults)

ASTCT ICANS

Apply Lee 2019 Table 6 adult ASTCT ICANS consensus grading and return the overall grade (0-4) as the most severe of the ICE, depressed LOC, seizure, motor, and ICP/edema domains, with icans true when grade is 1 or greater.

LIVE $0.005 USDC GET /api/calc/astct_icans

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

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

What it computes

Apply Lee 2019 Table 6 adult ASTCT ICANS consensus grading and return the overall grade (0-4) as the most severe of the ICE, depressed LOC, seizure, motor, and ICP/edema domains, with icans true when grade is 1 or greater.

When to use

When an agent already has a caller-assigned ICE total (0-10), depressed LOC category, seizure category, deep focal motor-weakness flag, and ICP/edema category, and needs the published adult ICANS grade. magent does not perform ICE testing, examine the patient, interpret EEG, or read imaging. Not CRS and not pediatric CAPD.

When not to use

• Not a medical device and not a diagnosis of ICANS.
• Adult Lee 2019 Table 6 only. Not pediatric CAPD. Not ASTCT CRS (Lee 2019 Table 1).
• ice_score is the caller-assigned ICE total (0-10). magent does not perform orientation, naming, following commands, writing, or attention testing and is not the 10-item ICE calculator.
• loc, seizure, motor_weakness, and icp are caller-assigned. magent does not examine the patient, interpret EEG, or read neuroimaging.
• Grade uses only findings not attributable to another cause; magent does not determine attribution.
• Motor weakness is published as N/A for grades 1-3; true maps to domain grade 4 (deep focal motor weakness such as hemiparesis or paraparesis).

Formula

Adult ASTCT ICANS grade = max of ICE, LOC, seizure, motor, and ICP domains not attributable to another cause (Lee 2019 Table 6). ICE: 10 → 0; 7-9 → 1; 3-6 → 2; 0-2 → 3; ICE 0 is 3 if awake (loc not unarousable) and 4 if unarousable/unable to perform ICE. loc: none 0, spontaneous 1, voice 2, tactile 3, unarousable 4. seizure: none 0, rapidly_resolving 3, life_threatening 4. motor_weakness true → 4 (N/A for grades 1-3), false → 0. icp: none 0, focal_edema 3, diffuse_edema 4. icans iff grade ≥ 1. Not CRS. Not the 10-item ICE test. magent does not perform ICE testing

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, Hegde M, Kadauke S, Gauthier J, Riviere I, van den Brink MRM, Gardner RA, Grupp SA, Kalos M, 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 ICANS
• ICANS grade
• immune effector cell-associated neurotoxicity
• CAR-T neurotoxicity
• ICE score ICANS
• Lee 2019 ICANS
• ASTCT consensus grading neurotoxicity
• adult ICANS Table 6

Try

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

/api/calc/astct_icans?ice_score=8&loc=none&seizure=none&motor_weakness=false&icp=none

Full URL: https://api.magentlab.com/api/calc/astct_icans?ice_score=8&loc=none&seizure=none&motor_weakness=false&icp=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_icans?ice_score=8&loc=none&seizure=none&motor_weakness=false&icp=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_icans 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": [
    {
      "ice_score": "8",
      "icp": "none",
      "loc": "none",
      "motor_weakness": "false",
      "seizure": "none"
    },
    {
      "ice_score": "8",
      "icp": "none",
      "loc": "none",
      "motor_weakness": "false",
      "seizure": "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_icans",
  "items": [
    {
      "loc": "none",
      "components": [
        {
          "value": 1,
          "factor": "ice",
          "met": true
        },
        {
          "value": 0,
          "factor": "loc",
          "met": false
        },
        {
          "value": 0,
          "factor": "seizure",
          "met": false
        },
        {
          "value": 0,
          "factor": "motor",
          "met": false
        },
        {
          "value": 0,
          "factor": "icp",
          "met": false
        }
      ],
      "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, Hegde M, Kadauke S, Gauthier J, Riviere I, van den Brink MRM, Gardner RA, Grupp SA, Kalos M, 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_icans",
      "formula_expression": "Adult ASTCT ICANS grade = max of ICE, LOC, seizure, motor, and ICP domains not attributable to another cause (Lee 2019 Table 6). ICE: 10 → 0; 7-9 → 1; 3-6 → 2; 0-2 → 3; ICE 0 is 3 if awake (loc not unarousable) and 4 if unarousable/unable to perform ICE. loc: none 0, spontaneous 1, voice 2, tactile 3, unarousable 4. seizure: none 0, rapidly_resolving 3, life_threatening 4. motor_weakness true → 4 (N/A for grades 1-3), false → 0. icp: none 0, focal_edema 3, diffuse_edema 4. icans iff grade ≥ 1. Not CRS. Not the 10-item ICE test. magent does not perform ICE testing",
      "grade": 1,
      "icans": true,
      "ice_grade": 1,
      "ice_score": 8,
      "icp": "none",
      "icp_grade": 0,
      "loc_grade": 0,
      "motor_grade": 0,
      "motor_weakness": false,
      "seizure": "none",
      "seizure_grade": 0
    },
    {
      "loc": "none",
      "components": [
        {
          "value": 1,
          "factor": "ice",
          "met": true
        },
        {
          "value": 0,
          "factor": "loc",
          "met": false
        },
        {
          "value": 0,
          "factor": "seizure",
          "met": false
        },
        {
          "value": 0,
          "factor": "motor",
          "met": false
        },
        {
          "value": 0,
          "factor": "icp",
          "met": false
        }
      ],
      "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, Hegde M, Kadauke S, Gauthier J, Riviere I, van den Brink MRM, Gardner RA, Grupp SA, Kalos M, 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_icans",
      "formula_expression": "Adult ASTCT ICANS grade = max of ICE, LOC, seizure, motor, and ICP domains not attributable to another cause (Lee 2019 Table 6). ICE: 10 → 0; 7-9 → 1; 3-6 → 2; 0-2 → 3; ICE 0 is 3 if awake (loc not unarousable) and 4 if unarousable/unable to perform ICE. loc: none 0, spontaneous 1, voice 2, tactile 3, unarousable 4. seizure: none 0, rapidly_resolving 3, life_threatening 4. motor_weakness true → 4 (N/A for grades 1-3), false → 0. icp: none 0, focal_edema 3, diffuse_edema 4. icans iff grade ≥ 1. Not CRS. Not the 10-item ICE test. magent does not perform ICE testing",
      "grade": 1,
      "icans": true,
      "ice_grade": 1,
      "ice_score": 8,
      "icp": "none",
      "icp_grade": 0,
      "loc_grade": 0,
      "motor_grade": 0,
      "motor_weakness": false,
      "seizure": "none",
      "seizure_grade": 0
    }
  ]
}

Response

Example JSON

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

{
  "loc": "none",
  "components": [
    {
      "value": 1,
      "factor": "ice",
      "met": true
    },
    {
      "value": 0,
      "factor": "loc",
      "met": false
    },
    {
      "value": 0,
      "factor": "seizure",
      "met": false
    },
    {
      "value": 0,
      "factor": "motor",
      "met": false
    },
    {
      "value": 0,
      "factor": "icp",
      "met": false
    }
  ],
  "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, Hegde M, Kadauke S, Gauthier J, Riviere I, van den Brink MRM, Gardner RA, Grupp SA, Kalos M, 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_icans",
  "formula_expression": "Adult ASTCT ICANS grade = max of ICE, LOC, seizure, motor, and ICP domains not attributable to another cause (Lee 2019 Table 6). ICE: 10 → 0; 7-9 → 1; 3-6 → 2; 0-2 → 3; ICE 0 is 3 if awake (loc not unarousable) and 4 if unarousable/unable to perform ICE. loc: none 0, spontaneous 1, voice 2, tactile 3, unarousable 4. seizure: none 0, rapidly_resolving 3, life_threatening 4. motor_weakness true → 4 (N/A for grades 1-3), false → 0. icp: none 0, focal_edema 3, diffuse_edema 4. icans iff grade ≥ 1. Not CRS. Not the 10-item ICE test. magent does not perform ICE testing",
  "grade": 1,
  "icans": true,
  "ice_grade": 1,
  "ice_score": 8,
  "icp": "none",
  "icp_grade": 0,
  "loc_grade": 0,
  "motor_grade": 0,
  "motor_weakness": false,
  "seizure": "none",
  "seizure_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.