Clinical calculator summary
CISNE Febrile Neutropenia Score
Clinical calculator summary
CISNE Febrile Neutropenia Score
A serious-complication score for apparently stable adults with solid tumors and febrile neutropenia.
Evidence-based context for fast calculator use
- Purpose:
- Refine risk assessment within clinically stable solid-tumor febrile neutropenia
- Population:
- Apparently stable adults with solid tumors and treatment-related febrile neutropenia
- Factors:
- ECOG status, COPD, Cardiovascular disease, Mucositis, Monocytes, Stress hyperglycemia
- Reference:
- Carmona-Bayonas et al., J Clin Oncol. 2015
CISNE Score (Febrile Neutropenia)
Two points for ECOG 2 or higher.
One point for grade 2 or higher.
One point below 200 cells/µL.
Selects the source-defined glucose threshold.
Two points above 120 mg/dL without diabetes, or at 250 mg/dL or higher with diabetes.
Clinical Context & Background
CISNE = 2×(ECOG ≥2) + COPD + chronic cardiovascular disease + NCI mucositis grade ≥2 + monocytes <200/µL + 2×(stress hyperglycemia). Stress hyperglycemia: glucose ≥121 mg/dL without diabetes or ≥250 mg/dL with diabetes.Reference Data
| Risk Class | Score | FINITE complication rate |
|---|---|---|
| Low Risk | 0 | 1.1% |
| Intermediate | 1-2 | 6.2% |
| High Risk | 3-8 | 36% |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use only after confirming apparent clinical stability in a patient with a solid tumor and febrile neutropenia.
- Use only when the patient and clinical setting match the population described for CISNE Febrile Neutropenia Score.
How To Interpret
- Increasing scores identify greater serious-complication risk; CISNE is not designed to rescue an unstable patient into outpatient care.
- Interpret thresholds with the entered units, current clinical status, and local guideline context.
What To Do Next
- Combine with MASCC, sepsis assessment, infection focus, organ function, oral tolerance, support, and reliable follow-up.
- Document the inputs, result, clinical judgment, and any reason for deviating from the model-guided pathway.
Limitations
- Do not apply to hematologic malignancy, obvious instability, or as a reason to delay antibiotics.
- This calculator supports clinical assessment and does not independently prescribe treatment.
Validated Population
Apparently stable adults with solid tumors and treatment-related febrile neutropenia
Clinical example
A patient who appears stable but has ECOG 2, COPD, and mucositis accumulates CISNE risk and should not be considered low risk from appearance alone.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed CISNE cases passed through visible production controls at scores 0, 2, and 8.
- No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/cisne-febrile-neutropenia-risk-index-2026-08-03.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 12 visible submissions.
- Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/cisne-febrile-neutropenia-risk-index.json.
: Public form simplified
- Combined the six adult, solid-tumor, chemotherapy, confirmed-FN, outpatient-onset, and apparent-stability eligibility questions into one early applicability confirmation.
- Preserved all seven score determinants, including the diabetes-dependent glucose threshold.
- The compact adapter projects confirmed applicability into the unchanged strict 13-key engine; the existing six-indicator neutropenia-panel compatibility path remains unchanged.
: Full validation test
- Passed 67/67 score, threshold, applicability, missing-input, malformed-input, and nonfinite-input checks.
- Confirmed score range 0-8 and FINITE classes: 0 low, 1-2 intermediate, and 3-8 high.
: Correction
- Corrected stress hyperglycemia from 1 point to the published 2 points, restoring the maximum score of 8.
- Added raw ECOG, mucositis, monocyte, glucose, and diabetes inputs with exact published thresholds.
- Added adult, solid-tumor, outpatient-onset, chemotherapy-context, confirmed-FN, and clinical-stability applicability checks.
- Removed wording that implied CISNE alone establishes outpatient safety.
Included in the current validation report.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Frequently Asked Questions
What is CISNE Febrile Neutropenia Score used for?
Refine risk assessment within clinically stable solid-tumor febrile neutropenia. It is intended for apparently stable adults with solid tumors and treatment-related febrile neutropenia.
Does CISNE Febrile Neutropenia Score determine treatment by itself?
No. Confirm the population, inputs, contraindications, competing risks, and current guideline recommendations before acting on the result.
Evidence-based oncology decision support. Verify with clinical guidelines.