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Risk scores for outpatient management of febrile neutropenia: Is the MASCC slipping?

Published:December 04, 2017DOI:https://doi.org/10.1016/j.ejim.2017.11.012
      In response to our recent narrative review [
      • Knight T.
      • Ahn S.
      • Rice T.W.
      • Cooksley T.
      Acute oncology care: a narrative review of the acute management of neutropenic sepsis and immune-related toxicities of checkpoint inhibitors.
      ], Carmona-Bayonas et al. question whether the Clinical Index of Stable Febrile Neutropenia (CISNE) or Multinational Association of Supportive Care in Cancer (MASCC) score is really the weakest in febrile neutropenia [
      • Carmona-Bayonas A.
      • Jimenez-Fonseca P.
      CISNE or MASCC, which predictor is really the weakest in febrile neutropenia?.
      ]. The basic premise is simple and broadly accepted – outpatient of patients with low risk febrile neutropenia is safe and effective [
      • Teuffel O.
      • Ethier M.
      • Alibhal S.
      • Beyene J.
      • Sung L.
      Outpatient management of cancer patients with febrile neutropenia: a systematic review and meta-analysis.
      ,
      • Cooksley T.
      • Holland M.
      • Klastersky J.
      Ambulatory outpatient management of patients with low risk febrile neutropaenia.
      ]. The question of how to identify these patients and develop safe pathways for their care in the myriad of settings that deliver emergency oncology care is significantly more challenging [
      • Cooksley T.
      • Rice T.
      Emergency oncology: development, current position and future direction in the US and UK.
      ].
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