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MASCC risk index for febrile neutropenia

Identifies low-risk febrile neutropenia suitable for oral/outpatient care.

MASCC risk index for febrile neutropenia
Burden of illness (clinical severity)
Systolic blood pressure
Chronic obstructive pulmonary disease
Tumour type / prior fungal infection
Dehydration requiring parenteral fluids
Status at onset of fever
Age
Result26 points

Score >=21: low risk of serious complications; may be a candidate for oral antibiotics and/or outpatient management with careful selection.

MASCC index (max 26)
26

When to use

  • Stratifying adults with chemotherapy-induced febrile neutropenia into low vs high risk.

Formula

Add points: burden of illness (none/mild 5, moderate 3, severe 0), no hypotension 5, no COPD 4, solid tumour or no prior fungal infection 4, no dehydration 3, outpatient at fever onset 3, age <60 = 2. Maximum 26; >=21 = low risk.

Pearls and pitfalls

  • The burden-of-illness item is a single clinical judgement, not additive across its levels.
  • Only low-risk patients without other concerning features should be considered for outpatient therapy.

References

  1. Klastersky J, et al. J Clin Oncol. 2000;18(16):3038-51.