MASCC Febrile Neutropenia Risk

Assess risk in febrile neutropenia and appropriateness for outpatient management

Questions

1.Burden of illness - Symptoms (subjective)?
2.Blood Pressure?
3.Active COPD?
4.Solid Tumour?
5.Previous Fungal Infection in a patient with a Hematologic malignancy?
6.Dehydration requiring parental fluids?
7.At onset of fever:
8.Age?

About

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

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.

A previous scoring system reported by Talcott et al. 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.

References

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.

Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology 2000, 18 (16): 3038-51

Klatersky et al.

Outpatient oral antibiotics for febrile neutropenic cancer patients using a score predictive for complications.

Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology 2006 September 1, 24 (25): 4129-34

Freifeld AG, Bow EJ, Sepkowitz KA, et. al.

Infectious Diseases Society of America. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America.

Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 2011 February 15, 52 (4): e56-93

Clin Infect Dis. 2011 Feb 15;52(4):e56-93.

The MASCC Febrile Neutropenia Risk calculator is created by QxMD.

Created by on 01/09/2015

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1. Burden of illness - Symptoms (subjective)?

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