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Clinical calculator summary

Febrile Neutropenia Triage Panel

A combined view of MASCC and CISNE for urgent febrile-neutropenia risk assessment.

Evidence-based context for fast calculator use

Purpose:
Expose agreement or discordance between complementary febrile-neutropenia tools
Population:
Adults with treatment-related febrile neutropenia after immediate stabilization and empiric-treatment planning
Factors:
MASCC low-risk features, CISNE stability criteria, Sepsis physiology, Logistical safety
Reference:
Klastersky et al., JCO 2000; Carmona-Bayonas et al., JCO 2015
HomeFebrile Neutropenia Triage
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Febrile Neutropenia Triage

Clinical Context & Background

This panel helps triage patients with chemotherapy-induced Febrile Neutropenia (FN).
1. MASCC Risk Index: The standard tool. Identifies "Low Risk" patients (Score ≥ 21) who may be eligible for home discharge.
2. CISNE Score: Specifically for patients with Solid Tumors who appear stable. A score of 0 indicates the highest safety for outpatient care.
Clinical Workflow:
If MASCC indicates Low Risk (≥21) AND CISNE indicates Low Risk (0), the patient is a strong candidate for outpatient management with oral antibiotics (e.g. Cipro/Augmentin), provided social support is adequate.
Primary Source EvidenceKlastersky J, Paesmans M, Rubenstein EB, 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.
Formula Logic
Parallel MASCC and CISNE calculation; discordant results require the more cautious clinical pathway.

Reference Data

ToolScoreInterpretation
MASCC≥ 21Low Risk (Safe for Outpatient?)
MASCC< 21High Risk (Admit for IV)
CISNE0Low Risk (Safe)
CISNE1 - 2Intermediate Risk (Observation?)
CISNE≥ 3High Risk (Admit)

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use after urgent assessment to compare MASCC and CISNE in an apparently stable adult with treatment-related febrile neutropenia.
  • Use only when the patient and clinical setting match the population described for Febrile Neutropenia Triage Panel.

How To Interpret

  • Discordant results should favor the more cautious pathway and direct clinical review rather than score averaging.
  • Interpret thresholds with the entered units, current clinical status, and local guideline context.

What To Do Next

  • Confirm antibiotics, cultures, stability, observation needs, oral tolerance, support, transport, and follow-up before disposition.
  • Document the inputs, result, clinical judgment, and any reason for deviating from the model-guided pathway.

Limitations

  • The panel must never delay sepsis treatment or be used to discharge an unstable patient.
  • This calculator supports clinical assessment and does not independently prescribe treatment.

Validated Population

Adults with treatment-related febrile neutropenia after immediate stabilization and empiric-treatment planning

Clinical example

A favorable MASCC score with an elevated CISNE score is discordant and should prompt caution rather than automatic outpatient management.

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Frequently Asked Questions

What is Febrile Neutropenia Triage Panel used for?

Expose agreement or discordance between complementary febrile-neutropenia tools. It is intended for adults with treatment-related febrile neutropenia after immediate stabilization and empiric-treatment planning.

Does Febrile Neutropenia Triage Panel 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.