The time has come for new models in febrile neutropenia: a practical demonstration of the inadequacy of the MASCC score

• A. Carmona-Bayonas ^[2] ; P. Jiménez-Fonseca ^[1] ; J. Virizuela Echaburu ^[3] ; M. Sánchez Cánovas ^[2] ; F. Ayala de la Peña ^[2]
  1. [1] Hospital Universitario Central de Asturias

     Hospital Universitario Central de Asturias

     Oviedo, España

     
  2. [2] Hospital Universitario Morales Meseguer, España
  3. [3] Hospital Universitario Virgen de la Macarena, España

  Mostrar afiliaciones +
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 19, Nº. 9 (September 2017), 2017, págs. 1084-1090
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Since its publication more than 15 years ago, the MASCC score has been internationally validated any number of times and recommended by most clinical practice guidelines for the management of febrile neutropenia (FN) around the world. We have used an empirical data-supported simulated scenario to demonstrate that, despite everything, the MASCC score is impractical as a basis for decision-making. A detailed analysis of reasons supporting the clinical irrelevance of this model is performed. First, seven of its eight variables are “innocent bystanders” that contribute little to selecting low-risk candidates for ambulatory management. Secondly, the training series was hardly representative of outpatients with solid tumors and low-risk FN. Finally, the simultaneous inclusion of key variables both in the model and in the outcome explains its successful validation in various series of patients. Alternative methods of prognostic classification, such as the Clinical Index of Stable Febrile Neutropenia, have been specifically validated for patients with solid tumors and should replace the MASCC model in situations of clinical uncertainty.