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Dr. Mohammadreza Dabiriفارسی
Clinical tool

MASCC Score for Febrile Neutropenia

Which patients with febrile neutropenia can be treated as outpatients?

Updated: 27 October 20261 min read3 references

For febrile neutropenia: a score of 21 or more means a low risk of serious complications.

Burden of illness

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An aid for clinicians; it does not replace clinical judgement, local protocols or the drug label. Double-check every result before prescribing.

Scoring

Seven variables with a maximum score of 26; 21 or more means low risk. In the original study its positive predictive value for no serious complication was 91% [1]. “Burden of illness” is a clinical judgement: none or mild 5, moderate 3, severe 0 [1].

Outpatient treatment: conditions

The ASCO/IDSA guideline suggests outpatient treatment for low-risk patients who [2]:

  • are clinically stable without a focal infection, pneumonia, catheter infection or need for intravenous therapy;
  • can take oral drugs, have a caregiver and can reach the hospital within about one hour;
  • are observed for some hours and receive the first antibiotic dose there.

Usual regimen: a fluoroquinolone (ciprofloxacin or levofloxacin) plus amoxicillin-clavulanate; clindamycin instead in penicillin allergy [2]. If the patient was on fluoroquinolone prophylaxis, oral outpatient treatment is not appropriate [2].

Limitation

MASCC is less valid in haematological malignancies with prolonged neutropenia (e.g., acute leukaemia induction or allogeneic transplant); these patients are usually admitted [3].

References

3 references
Show all references, 2 with a study cardClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    The Multinational Association for Supportive Care in Cancer risk index: A multinational scoring system for identifying low-risk febrile neutropenic cancer patientsKlastersky J, Paesmans M, Rubenstein EB, et al · J Clin Oncol · 2000;18:3038-51
    DOIPubMed Back to text: 1 2
  2. 2
    Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline UpdateTaplitz RA, Kennedy EB, Bow EJ, et al · J Clin Oncol · 2018;36:1443-1453
    Study cardDOIPubMed Back to text: 1 2 3
  3. 3
    Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of americaFreifeld AG, Bow EJ, Sepkowitz KA, et al · Clin Infect Dis · 2011;52:e56-93
    Study cardDOIPubMed Back to text

This page is based on reputable scientific sources and was last updated on 27 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/tools/mascc-score/

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