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MASCC Score for Febrile Neutropenia

Identifies low-risk febrile neutropenia patients who may be safely managed with oral antibiotics as outpatients — unusually, a higher score is better (low-risk ≥21).

High risk
MASCC <15 · high complication and mortality risk
Admit — consider ICU level of care
IV broad-spectrum antibiotics + close hemodynamic monitoring
9pts
Burden of illness at presentation
Tumour type
No hypotension (SBP ≥90 mmHg)
No COPD
No dehydration requiring IV fluids
Outpatient at onset of fever
Age <60 years
Max 26 · low-risk threshold ≥21 — higher is better, unlike most scores. Risk stratification, NOT a discharge pass: outpatient management also requires reliable follow-up, a caregiver at home, tolerance of orals, and none of the high-risk features the score misses (expected neutropenia >7 days, mucositis, hepatic/renal insufficiency).