5
Table 3. Multinational Association for Supportive Care in
Cancer (MASCC) Scoring System to Identify
Patients with Cancer and Febrile Neutropenia at
Low Risk of Medical Complications
a
Characteristic Weight
Burden of febrile neutropenia with no or mild symptoms
b
5
No hypotension (systolic blood pressure >90 mmHg ) 5
No chronic obstructive pulmonary disease
c
4
Solid tumor or hematologic malignancy with no previous fungal infection
d
4
No dehydration requiring parenteral fluids 3
Burden of febrile neutropenia with moderate symptoms
b
3
Outpatient status 3
Age <60 years 2
a
Maximum score is 26. Scores ≥21 indicate a low risk for medical complications.
b
Burden of febrile neutropenia refers to the general clinical status of the patient as influenced by the
febrile neutropenic episode. It should be evaluated on the following scale:
• No or mild symptoms (score of 5)
• Moderate symptoms (score of 3)
• Severe symptoms or moribund (score of 0).
Scores of 3 and 5 for burden of febrile neutropenia are not cumulative.
c
Chronic obstructive pulmonary disease means active chronic bronchitis, emphysema, decrease in
forced expiratory volumes, need for oxygen therapy and/or steroids and/or bronchodilators requiring
treatment at the presentation of the febrile neutropenic episode.
d
Previous fungal infection means demonstrated fungal infection or empirically treated suspected fungal
infection.
(Adapted from Klastersky J, et al. J Clin Oncol. 2006;24:4129-4134 and Freifeld AG, et al. Clin Infect
Dis. 2011;52:e56-e93.)
Table 2. Talcott's Groups for Stratifying Risk of Medical
Complications from Fever and Neutropenia
(Only those in Group 4 are considered at low risk.)
Group 1 Inpatients at onset of fever and neutropenia
Group 2 Outpatients with a serious acute comorbidity (defined as a medical condition
other than FN requiring inpatient observation or therapy)
Group 3 Outpatients with uncontrolled cancer (defined as leukemia not in complete
remission or, for other malignancies, progressive disease despite chemotherapy
or other evidence of treatment failure)
Group 4 Outpatients without serious comorbidity or uncontrolled cancer (thus at low
risk for medical complications from FN)
