MASCC Risk Index for Febrile Neutropenia

The MASCC Risk Index for Febrile Neutropenia identifies patients at low risk for serious complications to guide safe outpatient management 1.

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Burden of illness (symptom severity)
Hypotension (sBP < 90 mmHg)
Active COPD
Type of cancer
Dehydration requiring IV fluids
Status at onset of fever
Age (years)

使用適応

Used for adults with cancer and new febrile neutropenia to identify low‑risk patients (score ≥21) who may be safely considered for early discharge and outpatient oral antibiotics when clinically stable, per ASCO/IDSA guidance 1 [Level I evidence] and validated in the original multinational cohort showing PPV 91% and sensitivity 71% for low‑risk classification 2 [Level I evidence].

洞察と注意事項

Identifies low‑risk episodes suitable for outpatient care but can miss complications. In the original multinational validation, score ≥21 yielded PPV 91%, sensitivity 71%, specificity 68% 1 [Level I evidence]. Performance drops in some real‑world or high‑comorbidity cohorts, with sensitivity as low as 45% and PPV 11% 2 [Level II evidence]. Underestimates risk in “apparently stable” FN compared with CISNE 3 [Level II evidence]. Use only with clinical judgment and social/medical exclusion criteria.