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[Prognosis prediction of febrile neutropenia by MASCC score: A retrospective study]
Louise Cervetti1, Alexis Vallard2, Sylvestre Le Moulec1
1Hôpital d'instruction des armées du Val-de-Grâce, service d'oncologie et radiothérapie, boulevard du Port-Royal, 75013 Paris, France.
Introduction:
The score of the MASCC, by means of clinical criteria, estimates the risk of serious complications in patients with neutropenic fever induced by chemotherapy.
Methods:
We retrospectively studied a cohort of patients hospitalized for a neutropenic fever and analyzed complications according to the criteria defined by the MASCC.
Results:
Eighty-one neutropenic fevers in 71 patients were identified. Microbiological documentation was obtained in 33% of cases only. Fifty-eight patients (72%) presented with a MASCC score≥21 and were considered as low risk of complications. In the total population, 10 patients died during their hospitalizations for neutropenic fever, 7 in the high-risk group versus 3 in the low risk group, including 2 patients suffering from significant comorbidities not taken into account by MASCC score. Within the low risk group, presence of a metastatic disease and existence of 2 or more comorbidities were associated with a longer duration of hospitalization.
Conclusion:
This analysis suggests that the criteria of the MASCC are not always enough to thoroughly identify which patients were at risk of complications or could be treated through outpatient management. By better taking into account the comorbidities and tumoral stage, a better selection of the patients who are likely to receive an ambulatory treatment could be made. To date, hospitalization remains frequently necessary in neutropenic fevers, at least in its initial steps, and the place of the general practitioner remains to be better defined.
Insights
The Multinational Association of Supportive Care in Cancer (MASCC) score may not fully identify neutropenic fever patients at risk for complications. Comorbidities and tumor stage require better consideration for outpatient treatment selection.
Area of Science:
- Oncology
- Hematology
- Infectious Diseases
Background:
- The Multinational Association of Supportive Care in Cancer (MASCC) score is used to assess the risk of severe complications in patients experiencing neutropenic fever following chemotherapy.
- Neutropenic fever is a common and serious side effect of chemotherapy, necessitating careful risk stratification.
Purpose of the Study:
- To retrospectively evaluate the effectiveness of the MASCC score in identifying patients with neutropenic fever who are at risk of complications.
- To explore factors beyond the MASCC score that may influence complication risk and hospitalization duration.
Main Methods:
- Retrospective analysis of a cohort of hospitalized patients diagnosed with neutropenic fever.
- Assessment of patient complications based on the established criteria of the MASCC score.
Main Results:
- Of 71 patients (81 episodes), 72% had a MASCC score ≥21, indicating low risk. However, 10 deaths occurred, with a higher proportion in the high-risk group.
- Comorbidities not accounted for by the MASCC score impacted outcomes in 2 deceased patients.
- Within the low-risk group, metastatic disease and multiple comorbidities were linked to longer hospital stays.
Conclusions:
- The MASCC score alone may be insufficient for accurately identifying all patients at risk of complications or suitable for outpatient management.
- Incorporating comorbidities and tumor stage into risk assessment could improve patient selection for ambulatory treatment.
- Hospitalization remains crucial for initial neutropenic fever management, and the role of general practitioners needs further definition.
