The Cardiovascular
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Clinical Index of Stable Febrile Neutropenia (CISNE)

Risk of serious complications in stable febrile neutropenia from solid tumours.

Clinical Index of Stable Febrile Neutropenia (CISNE)
ECOG performance status ≥ 2
Stress-induced hyperglycaemia
Chronic obstructive pulmonary disease
Chronic cardiovascular disease
NCI mucositis grade ≥ 2
Monocytes < 200 /µL
Result0 points

Low risk; approximate complication rate ~1.1 %.

Risk group
Low risk
Approx. complication rate
~1.1 %

When to use

  • Identifying apparently stable febrile neutropenia patients who can be considered for outpatient management.

Formula

Points: ECOG ≥ 2 (2), stress hyperglycaemia (2), COPD (1), chronic cardiovascular disease (1), mucositis grade ≥ 2 (1), monocytes < 200/µL (1). Range 0–8; 0 low, 1–2 intermediate, ≥ 3 high.

Pearls and pitfalls

  • Applies only to clinically stable adults with solid tumours — not to unstable patients or haematological malignancy.
  • Intended to complement, not replace, MASCC risk assessment.

References

  1. Carmona-Bayonas A, et al. J Clin Oncol. 2015;33(5):465-71.