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MASCC index

Identifies adults with cancer and febrile neutropenia at low risk of serious complications who may be candidates for oral antibiotics and outpatient care.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

MASCC/Klastersky 2000: 7 domains, total 0–26, cutoff ≥21; ASCO/IDSA 2018 context

MASCC ≥21 indicates a lower risk of complications but does not, on its own, authorize discharge, oral antibiotics or outpatient management. In the ASCO/IDSA 2018 context, selection depends on clinical assessment, stability, comorbidities, ability to attend return visits, a caregiver at home, and access to a telephone and transport. Candidates for outpatient management must be observed for at least 4 hours before discharge and require follow-up. The hypotension criterion in this implementation follows the original 2000 variable: SBP <90 mmHg.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Burden of illness (symptoms of the febrile episode)
Hypotension (systolic blood pressure < 90 mmHg)
Active COPD
Cancer type
Dehydration requiring intravenous fluids
Where fever began
Age

3/3 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Burden of illness: none/mild 5, moderate 3, severe 0 · no hypotension 5 · no COPD 4 · solid tumour 4, or haematological malignancy without prior fungal infection 4 · no dehydration 3 · outpatient 3 · age <60 years 2. Maximum: 26.

References

Identifier: mascc

Original clinical content: Brazilian Portuguese.

Method version

MASCC/Klastersky 2000: 7 domains, total 0–26, cutoff ≥21; ASCO/IDSA 2018 context

mascc@native-2026-10-03+4154cec7c296

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (3)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Burden of illness (symptoms of the febrile episode): None or mild
Hypotension (systolic blood pressure < 90 mmHg): No
Active COPD: No
Cancer type: Solid tumor, or hematological malignancy without prior fungal infection
Dehydration requiring intravenous fluids: No
Where fever began: Outpatient
Age: < 60 years

{
  "carga": "5",
  "hipotensao": "5",
  "dpoc": "4",
  "tumor": "4",
  "desidratacao": "3",
  "local": "3",
  "idade": "2"
}

Expected result

{
  "score": 26,
  "level": "low"
}

Actual result

{
  "score": 26
}

Case 2

reference-002

Inputs

Burden of illness (symptoms of the febrile episode): Moderate
Hypotension (systolic blood pressure < 90 mmHg): No
Active COPD: No
Cancer type: Solid tumor, or hematological malignancy without prior fungal infection
Dehydration requiring intravenous fluids: No
Where fever began: During hospitalization
Age: < 60 years

{
  "carga": "3",
  "hipotensao": "5",
  "dpoc": "4",
  "tumor": "4",
  "desidratacao": "3",
  "local": "0",
  "idade": "2"
}

Expected result

{
  "score": 21,
  "level": "low"
}

Actual result

{
  "score": 21
}

Case 3

reference-003

Inputs

Burden of illness (symptoms of the febrile episode): Moderate
Hypotension (systolic blood pressure < 90 mmHg): Yes
Active COPD: No
Cancer type: Solid tumor, or hematological malignancy without prior fungal infection
Dehydration requiring intravenous fluids: No
Where fever began: Outpatient
Age: ≥ 60 years

{
  "carga": "3",
  "hipotensao": "0",
  "dpoc": "4",
  "tumor": "4",
  "desidratacao": "3",
  "local": "3",
  "idade": "0"
}

Expected result

{
  "score": 17,
  "level": "high"
}

Actual result

{
  "score": 17
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

Specific oncological application

A complication index in febrile neutropenia in adults with cancer. Eligibility, signs of severity and management decisions require a specific clinical assessment.

Applications: Adverse effects and safety