Febrile Neutropenia | MASCC

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Use this calculator to determine risk of serious complications in febrile neutropenia using the MASCC Risk Score.

Burden of illness—subjective symptoms
BP is > 90 systolic
Active COPD*
Solid Tumour
Previous Fungal infection in Patient with a Hematologic Malignancy
Dehydration Requiring IV Fluids
Clinical Setting at Onset of Fever
Age < 60

*Active COPD defined as active chronic bronchitis, emphysema, decrease in forced expiratory volumes, and need for oxygen therapy, corticosteroids, and/or bronchodilators.

About this calculator

The Multinational Association for Supportive Care in Cancer (MASCC) Risk Index can be used to identify low-risk patients (score ≥ 21 points) for serious complications of febrile neutropenia (including death, intensive care unit admission, confusion, cardiac complications, respiratory failure, renal failure, hypotension, bleeding, and other serious medical complications). The score was developed to select patients for therapeutic strategies that could potentially be more convenient or cost-effective. Prospective studies evaluating the use of the MASCC score to identify patients that can be managed with early oral antibiotics or out-of-hospital are ongoing._

Citations

The MASCC study was an international collaboration to derive and validate a scoring system to identify low-risk patients for complications of febrile neutropenia.

Klatersky et al. The Multinational Association for Supportive Care in Cancer Risk Index: A Multinational Scoring System for Identifying Low-Risk Febrile Neutropenic Cancer Patients. J Clin Onc 18:3038-3051. (2000)

A previous scoring system reported by Talcott et al.

Talcott et al. The medical course of cancer patients with fever and neutropenia: clinical identification of a a low-risk subgroup at presentation. Arch Intern Med 148:2561-2568. (1988)

This work has also been used to identify low-risk patients that can be successfully treated as outpatients with intravenous or oral antibiotics. The MASCC score has compared favorably with the Talcott score with fewer misclassifications of low-risk patients and improved sensitivity.

Initial pilot studies using the MASCC score to define strategies for low-risk patients have been completed by Klatersky et al.

Klatersky et al. Outpatient oral antibiotics for febrile neutropenic cancer patients using a score predictive for complications. JCO 24:4129-4134. (2006)

Contributor

QxMD Hematology contributing author: Dr. Matthew Cheung, MD, SM, FRCP(C)