Solid tumour, or haematological malignancy with no previous fungal infection
No dehydration requiring parenteral fluids
Outpatient at onset of fever
Age < 60 years
Select the burden of illness
Evidence
Original publication
Klastersky 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. A score ≥ 21 predicted low risk of serious complications with a positive predictive value of ~91%, sensitivity 71% and specificity 68%.
Journal of Clinical Oncology, 2000
Open source
Guideline
ASCO/IDSA and ESMO febrile-neutropenia guidance: a MASCC score ≥ 21 with no other adverse features (able to tolerate oral drugs, adequate home support, close follow-up) may allow oral antibiotics and/or outpatient management; a score < 21, or clinical concern, warrants admission and IV empirical antibiotics. The score does not replace clinical judgement, and the CISNE score may better identify high-risk patients who appear clinically stable.
Last reviewed: 2026-09
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MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.