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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.
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 2000 18:3038-3051)
Talcott et al.
The medical course of cancer patients with fever and neutropenia: clinical identification of a low-risk subgroup at presentation.
Arch Intern Med 1988 148:2561-2568)
Klatersky et al. Outpatient oral antibiotics for febrile neutropenic cancer patients using a score predictive for complications. JCO 2006:24:4129-4134).
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.
Clin Infect Dis. 2011 Feb 15;52(4):e56-93.