Score range: 0 to 26. A score of 21 or higher suggests lower risk in febrile neutropenia.
What is the MASCC calculator?
The MASCC (Multinational Association for Supportive Care in Cancer) score helps clinicians estimate risk in adults with febrile neutropenia. In simple terms, it supports fast risk stratification when a cancer patient develops fever during neutropenia. Higher scores generally indicate lower risk for serious complications.
Why this score matters in oncology triage
Febrile neutropenia can become dangerous quickly. The MASCC index gives care teams a structured method for deciding whether a patient is likely to need aggressive inpatient management or may be suitable for lower-intensity pathways, depending on local protocols and full clinical assessment.
- Supports emergency and oncology decision-making.
- Improves consistency in risk assessment.
- Helps identify potentially low-risk patients (MASCC ≥ 21).
- Should always be interpreted with exam findings, labs, and clinician judgment.
MASCC scoring criteria and points
Core variables used
- Burden of illness: No/mild (5), Moderate (3), Severe (0)
- No hypotension: Systolic BP > 90 mmHg (5)
- No COPD: (4)
- Solid tumor or no prior fungal infection in hematologic malignancy: (4)
- No dehydration requiring parenteral fluids: (3)
- Outpatient at onset of fever: (3)
- Age under 60 years: (2)
Maximum score is 26. Common interpretation cutoff: 21 points.
How to interpret results
MASCC score 21 or above
Generally considered lower risk of severe complications. In selected patients, this may support outpatient treatment plans, oral antibiotics, and close follow-up when institution criteria are met.
MASCC score below 21
Suggests higher risk. These patients often require inpatient monitoring, IV antimicrobial therapy, and more intensive observation for sepsis, hemodynamic instability, and organ dysfunction.
Example of a quick calculation
If a patient has mild symptoms (5), no hypotension (5), no COPD (4), meets malignancy criterion (4), no dehydration (3), fever started as outpatient (3), and age 45 (2), the total is 26, the highest possible score.
Limitations and safe use
- MASCC is a decision-support tool, not a stand-alone diagnosis.
- Does not replace blood cultures, absolute neutrophil count trends, lactate, or imaging when needed.
- Local oncology pathways and antimicrobial guidelines should always be followed.
- Clinical deterioration can occur even in patients with higher scores.