For example, if a patient with r/r ALL develops hypotension requiring low-dose vasopressors after anti-CD19 CAR T cell therapy, they would be considered grade 3 on the Penn grading scale, grade 4 on the CTCAE scale (due to lack of differentiation between low-dose and high-dose vasopressors in the CTCAE system), and grade 2 on the 2014 Lee et al. scale recently (Table 2). The gene discussed is CD19; the disease is acute lymphoblastic leukemia.