ICE Score Calculator
Immune Effector Cell Encephalopathy score for neurocognitive assessment in adults receiving CAR T-cell therapy.
10: No impairment7–9: ICE severity consistent with grade 13–6: ICE severity consistent with grade 20–2: ICE severity consistent with grade 30 + unarousable/unable to perform ICE: grade 4
The Immune Effector Cell Encephalopathy (ICE) score is a 10-point bedside neurologic screening tool used to assess neurocognitive function in patients receiving immune effector cell therapies, especially CAR T-cell therapy. It is part of the ASTCT framework for evaluating ICANS (immune effector cell–associated neurotoxicity syndrome).
It measures 5 areas:
- Orientation to year, month, city, and hospital = 4 points
- Naming 3 objects = 3 points
- Following commands = 1 point
- Writing a standard sentence = 1 point
- Attention by counting backward from 100 by tens = 1 point
The total score runs from 0 to 10, and lower scores mean worse encephalopathy. In common clinical use:
- 10 = normal
- 7–9 = mild impairment
- 3–6 = moderate impairment
- 0–2 = severe impairment
One important detail: the ICE score is not the same thing as the full ICANS grade. Full ICANS grading also considers level of consciousness, seizures, motor findings, and evidence of raised intracranial pressure/cerebral edema. For example, an ICE score of 0 can correspond to different ICANS grades depending on whether the patient is awake or unarousable.
So in plain language, the ICE score is a quick structured way to check how much CAR T-related neurocognitive dysfunction a patient has at the bedside.
