MASCC Risk Index for Febrile Neutropenia
Multinational Association for Supportive Care in Cancer (MASCC) score identifies low-risk febrile neutropenia patients suitable for oral antibiotics and potential outpatient management.
Score interpretation
MASCC < 21: High-risk febrile neutropenia. Serious complications likely.
→ Admit. IV broad-spectrum antibiotics within 1 hour: piperacillin-tazobactam 4.5g IV TDS or meropenem 1g IV TDS if penicillin allergy or prior ESBL. Add vancomycin if line infection, MRSA risk, or haemodynamically unstable. Haematology/oncology review. Blood cultures × 2 sets (peripheral + line), urine, CXR before antibiotics.
MASCC ≥ 21: Low-risk febrile neutropenia. Serious complications uncommon (~6%).
→ Consider oral antibiotics (ciprofloxacin 500mg BD + co-amoxiclav 625mg TDS) if: tolerating oral, no IV line infection, no significant comorbidities. Can consider outpatient if reliable, close follow-up arranged, and patient educated on return triggers. Haematology/oncology team agreement required.
Interpretation bands for the MASCC Score. Apply clinical judgement and local guidance.
References
- Klastersky J, 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 Oncol. 2000;18(16):3038–3051.
- NICE NG144. Neutropenic sepsis: prevention and management in people with cancer. 2012 (updated 2021).
Related
Curated clinical cross-links plus same-class fallbacks.
- Meropenem (Paediatric) · Carbapenem — Severe / MDR Gram-Negative Infections / Febrile Neutropenia
- Folinic Acid (Calcium Folinate / Leucovorin) · Antidote / Chemotherapy Support
- Zoledronic Acid · Bisphosphonate (IV)
- Denosumab · RANK Ligand Inhibitor (Anti-resorptive)
- Cisplatin · Platinum Chemotherapy — Head and Neck Cancer
- Methotrexate · Chemotherapy / Immunosuppressant — Head and Neck / Granulomatosis
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.