The MASCC score (Multinational association for supportive care in cancer risk index) is an aid to identify patients presenting low risk during febrile neutropenia, and possibly being treated on an outpatient basis. A score ≥ 21 means the risk is low.
The polymorphonuclear neutrophil (PNN) is a cell involved in the early stages of the immune response. It is involved in the destruction of pathogens and their elimination in the form of pus. The decrease in their blood level or neutropenia, therefore, exposes them to mainly bacterial infections and fungal.
The WHO has distinguished several grades of severity of neutropenia induced by chemotherapy (grade 1 < 2,000/mm3, grade 2 < 1,500/mm3, grade 3 < 1,000/mm3, and grade 4 < 500/mm3). The risk of developing an infection is high below 500 PNN/mm3, it is greater than 100/mm3. Neutropenia likely to fall below 500 PNN/mm3 within the next 24 hours has the same meaning.
The febrile nature of neutropenia is defined by a temperature greater than or equal to 38.3°C in a single dose or greater than or equal to 38°C measured twice within an hour interval.
The cause of neutropenia is often obvious: it is a side effect of cytotoxic chemotherapy or a blood disease revealing itself by bone marrow failure. However, neutropenia can have many causes, some of which are rare.