Table 5.6.6-A 
Graded Toxicity Scale To Define Adverse Reactions 1 
CATEGORY 
1 
PARAMETERS 
Grade 1 
(Minimal) 
Grade II 
(Moderate) 
Grade III 
(Severe) 
Grade IV 
(Intolerable) 
' A HEMATOLOGIC 2 
1) WBC 
2) Granulocytes 
3) Platelets 
2501-3000/mm 5 
1251— 1500/nm 5 
75,001-100,000/mm 5 
1500-2500/mm 5 
751-1250/mm 5 
50,001-75,000/mm 5 
1000-1500/mm 5 
500—750/mm 5 
25,000-50,000/mm 5 
<1000/mm 5 
<500/mm 5 
<25, 000/mm 5 
R COAGULATION 5 
1) Prothrombin time 
1 
2) Partial thrombo- 
plastin time 
14-16 sec 
40-45 sec 
17-18 sec 
46-50 sec 
>19 sec without 
bleeding 
>51 sec without 
bleeding 
>19 sec with 
bleeding 
>51 sec with 
bleeding 
C. EEPATIC* 
1) Bilirubin 
2) SGOT 
1. 5-2.0 mg percent 
50-150 IU 
2. 1-2. 5 mg percent 
151-300 IU 
2. 6-3.0 mg percent 
301-600 IU 
>3.0 mg percent 
>600 IU 
D. RENAL 
1) BUN 
2) Creatinine 
25-50 mg percent 
2. 0-2. 5 mg percent 
51-75 mg 
2. 6-3.0 mg percent 
76-100 mg percent 
3. 1-3. 5 mg percent 
>100 mg percent 
>3.5 mg percent 
E. GASTROINTESTINAL 
1) Nausea/vomiting 
Nausea alone 
<5 emeses /day 
>5 emeses/day 
Intractable vomiting/needs IV 
2) Diarrhea 5 
3-4 loose stools 
a day 
5—7 loose to 
watery stools a day 
>7 stools a day 
Bloody diarrhea or 
needs IV fluids 
3) Anorexia/ 
weight loss 
Anorexia without 
weight loss 
<5 percent weight 
loss 
5-10 percent weight 
loss 
>10 percent weight loss 
A) Stomatitis 
Sore mouth 
<3 discrete ulcers 
>3 discrete ulcers 
>3 discrete ulcers 
unable to eat 
F. FATIGUE 
Fatigue without de- 
crease in activities 
of daily living 
In bed <50 percent 
of the day 
In bed > 50 percent 
of the day 
Unable to care for self 
G. NEUROLOGIC 
1) Peripheral 
Transient (<12 hrs) 
numbness or 
paresthesia 
Persistent ( >12 hrs) 
numbness or 
paresthesia 
Decrease of deep 
tendon reflexes 
Motor weakness or 
autonomic dysfunction 
2) Central 
Mild difficulty 
with concentration 
Moderate difficulty 
with concentration 
Confusion 
disorientation 
Coma, seizures 
H. FEVER 2 * 
T 38 . 0-39 . 0°C 
T 39.0— 40”C 
T 40-42”C 
T >42°C 
I. HYPOTENSION 
20-25 percent drop 
from baseline systoli 
26-30 percent drop 
c from baseline systolic 
31-40 percent drop 
from baseline 
systolic 
>40 percent drop 
from baseline systolic, 
symptomatic 
J. RIGORS 
Not requiring 
medication 
occurring with the 
use of medication 
symptomatic hypo- 
tension, acro- 
cysnosis, severe 
tachyprise 
rigors associated 
with Grade III toxi- 
city hypotension 
requiring medication 
K. PULMONARY 7 
15-20 percent decrease 21—30 percent 
from baseline decrease from 
baseline 
31-50 percent 
decrease from 
baseline 
>50 percent decrease 
from baseline 
L. BRONCHIAL 
Visible hemorrhage 
visible hemorrhage/ 
ulceration 
active ulceration/ 
ulceration/ 
increased edema 
massive bleeding and 
edema 
i 
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