Saved Results

No results saved yet.

Enter a patient name and hit Save on a result.

Clinical calculator summary

Original CRASH 2012 toxicity groups

Parallel hematologic, non-hematologic, and combined scores using regimen MAX2 and pretreatment geriatric/laboratory factors.

Evidence-based context for fast calculator use

Purpose:
Reproduce the original source score groups without deriving MAX2 or recommending treatment.
Population:
Adults age 70 or older before starting a new cytotoxic chemotherapy regimen with exact-regimen MAX2 available.
Factors:
Externally established MAX2, DBP, IADL, LDH and local ULN, ECOG, MMSE, MNA
Reference:
Extermann M, et al. Cancer. 2012. DOI 10.1002/cncr.26646. PMID 22072065.
HomeOriginal CRASH Chemotherapy Toxicity Score (2012)
Pin your most used calculators here by clicking the star in the dropdown.

Original CRASH Chemotherapy Toxicity Score (2012)

MAX2 must already be established externally for the exact regimen; this calculator does not derive it.

Clinical Context & Background

The original CRASH model separates hematologic, non-hematologic, and combined severe chemotherapy toxicity groups in adults age 70 or older before a new cytotoxic regimen. It uses raw diastolic blood pressure, IADL, LDH with same-laboratory ULN, ECOG, MMSE, MNA, and an externally established MAX2 value for the exact regimen.
MAX2 is not guessed from a regimen name or calculated by this route. The entered value must already be established for the exact regimen, including its source-specific supportive-care context. If it is unavailable or uncertain, the route withholds all scores.
Displayed derivation and validation incidences are historical cohort observations for CTCAE v3 grade 4 hematologic and grade 3-4 non-hematologic toxicity. They are not individualized probabilities and do not prescribe dose, regimen, growth-factor use, monitoring, or treatment.
Primary Source EvidenceExtermann M, Boler I, Reich RR, et al. Predicting the risk of chemotherapy toxicity in older patients: the CRASH score. Cancer. 2012;118:3377-3386. DOI 10.1002/cncr.26646. PMID 22072065.
Formula Logic
H = MAX2 + DBP + IADL + LDH; NH = MAX2 + ECOG + MMSE + MNA; combined = H + NH - MAX2.

Reference Data

DomainLowIntermediate-lowIntermediate-highHigh
Hematologic0-12-34-56
Non-hematologic0-23-45-67-8
Combined0-34-67-910-12

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Before a new cytotoxic chemotherapy regimen in an adult age 70 or older.
  • Only when MAX2 has been externally established for that exact regimen and every raw assessment value is available.

How To Interpret

  • Read the hematologic, non-hematologic, and combined scores and source groups separately.
  • Historical cohort incidences describe the derivation and validation samples; they are not patient-specific probabilities.

What To Do Next

  • Interpret the three source groups with the complete geriatric assessment, regimen context, goals, and current clinical guidance.

Limitations

  • Does not calculate or guess MAX2 from a regimen name.
  • Does not apply below age 70, after treatment starts, or when no new cytotoxic regimen is being started.
  • Does not recommend a regimen, dose modification, growth factor, monitoring schedule, or treatment decision.
  • The original endpoints use CTCAE version 3 and transportability may vary in contemporary populations and regimens.

Validated Population

Original development/validation cohorts of older adults receiving chemotherapy; source route restricted to age 70 or older.

Calculation verification history

Verified

  1. : Production browser revalidation

    • Three source-backed cases passed through the applicability gate and all eight visible production controls at minimum, exact MAX2 0.45 transition, and maximum profiles.
    • Hematologic, non-hematologic, and combined CRASH scores remained independent and matched 0/0/0, 1/1/1, and 6/8/12 with the correct group labels.
    • No unexpected N/A, stale control, literal undefined/null value, or browser-console error was observed.
    Download latest production check (Excel)

    Case-level evidence is retained in validation/browser-revalidation/crash-chemotherapy-toxicity-2026-08-03.json.

  2. : Production browser validation

    • Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
    • Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
    • Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.

    Case-level production evidence is retained in validation/browser-production/crash-chemotherapy-toxicity.json.

  3. : Model identity and source lock corrected

    • Locked the route to the original 2012 CRASH model and the Moffitt source worksheets.
    • Separated CRASH from CARG, CARG-BC, G8, regimen-name inference, and treatment guidance.

  4. : Inputs and calculation corrected

    • Replaced seven favorable pre-scored defaults with an immutable exact twelve-key raw-input contract and explicit age, timing, treatment, and MAX2 provenance gates.
    • Restored the local-ULN LDH rule, exact MAX2 boundaries, all three source scores and groups, and historical cohort observation labels.
    • Removed coercion, guessed MAX2, individualized probability, and treatment or supportive-care directives.

  5. : Full validation completed

    • Passed 3072 of 3072 deterministic assertions using a separately encoded literal oracle.
    • Workbook and complete JSON evidence were mirrored publicly after all report checks passed.

    Software implementation verification only; not prospective clinical validation.

  6. : Public form simplified

    • Combined age-70 threshold, pretreatment timing, new-cytotoxic-regimen context, and exact-regimen MAX2 provenance into one early applicability confirmation.
    • Preserved all eight raw scoring inputs, including exact-regimen MAX2 and same-laboratory LDH with its ULN.
    • The compact adapter projects confirmed applicability into the unchanged strict 12-key engine; declined or uncertain applicability stops before scoring entry.

    Public-form parity is covered by the calculator entry-burden audit; the verified score engine, source groups, and report remain unchanged.

Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.

Found a possible issue? Report it to improve this calculator

Share This Calculator

Share:

Related Tools

CARG-BC Breast Chemotherapy Toxicity

Frequently Asked Questions

Can this calculator determine MAX2 from a regimen name?

No. MAX2 must be externally established for the exact regimen. The route does not guess, interpolate, or derive it.

Are the displayed incidences my patient’s toxicity probability?

No. They are historical derivation- and validation-cohort observations for the matched group, not individualized probability estimates.

Does a high group mandate dose reduction or growth-factor use?

No. CRASH does not prescribe treatment, dosing, prophylaxis, or monitoring.

Evidence-based oncology decision support. Verify with clinical guidelines.