MASCC Risk Index for Febrile Neutropenia
The Multinational Association for Supportive Care in Cancer (MASCC) risk index identifies low-risk febrile neutropenia patients suitable for outpatient oral antibiotic therapy. Score 0-26.
Warnings:
- MASCC >=21 predicts >91% of patients who do not have serious medical complications during febrile neutropenia
- However, high MASCC does NOT guarantee absence of bacteremia or sepsis
- False positive rate: 8.6% (some patients with score >=21 develop serious complications)
- Must only be used after thorough clinical evaluation in stable patients
- Recommended outpatient regimen: oral moxifloxacin OR amoxicillin-clavulanate + ciprofloxacin
- Exclusion criteria for outpatient therapy: hemodynamic instability, pneumonia, severe abdominal pain, CNS symptoms, or clinically unstable
- Some experts consider additional 3 points if burden is moderate without symptoms
Note: Maximum score = 26. Burden of illness scoring: No/mild = 5; Moderate = 3; Severe = 0. Developed in 2000 and validated internationally. Core questions are burden of illness, hypotension, COPD, solid tumor type, dehydration, outpatient status, and age.
No symptoms or mild symptoms = 5; moderate symptoms = 3; severe symptoms = 0 (no outpatient treatment)
Systolic blood pressure >=90 mmHg without supportive measures
No history of chronic obstructive pulmonary disease
Solid tumor or no prior fungal infection = 4; hematologic malignancy with previous fungal infection = 0
No clinical or radiographic evidence of dehydration
Patient was outpatient at onset of fever
Age less than 60 years
References
- The MASCC Risk Index Score Can Guide Safe Outpatient Therapy of Cancer Patients with Low-Risk Febrile Neutropenia - Journal of Clinical Medicine / PMC (2024)
- Use of the MASCC risk index score in identification of low-risk febrile neutropenic patients - Journal of the Egyptian National Cancer Institute / PMC (2017)
- MASCC Risk Index for Febrile Neutropenia - MDCalc - MDCalc (2018)
Medical Disclaimer
This calculator is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.