Immune Effector Cell Associated Encephalopathy (ICE) TOOL

The ICE tool is a 10‑point bedside cognitive assessment used to rapidly screen for ICANS in adults receiving immune effector cell therapies.

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Orientation to year, month, city, hospital
Ability to name 3 objects
Ability to write a standard sentence
Ability to count backwards from 100 by 10

Indications d'utilisation

Used in all adults receiving CAR‑T or other immune‑effector cell therapies to screen, score, and track early neurotoxicity as part of ICANS grading. Provides a rapid bedside assessment of orientation, naming, commands, writing, and attention, performed twice daily to detect earliest encephalopathy signs and guide ICANS grading and steroid escalation, per EBMT/EHA best‑practice recommendations 1 [Level I evidence].

Informations et précautions

Start with the 10‑point bedside neurologic screen assessing orientation, naming, command following, handwriting, and attention; a decline signals evolving ICANS and mandates urgent reassessment. Insights: highly sensitive for early cognitive changes and integrates directly into ASTCT ICANS grading 1. Cautions: may miss focal deficits, seizures, and encephalopathy with normal ICE; requires twice‑daily use; deterioration should prompt EEG/MRI/LP to exclude mimics.