The prediction of serious complications in patients with febrile neutropenia according to their CISNE and MASCC scores

Abstract

Objective. In Japan, the Multinational Association of Supportive Care in Cancer (MASCC) score has been used to predict serious complications in patients who are suspected of having febrile neutropenia (FN). The Clinical Index of Stable Febrile Neutropenia (CISNE) score has recently been shown to be useful in the prediction of serious complications in such patients abroad. We therefore evaluated the application of the CISNE score in Japan. Methods. We retrospectively searched for inpatients who received chemotherapy in our ward and who experienced FN between April 2011 and March 2015. We compared the risks factors for serious complications in the MASCC and CISNE scores. Results. Seventy-two patients (lung cancer, n=38; malignant lymphoma, n =16; gastrointestinal cancer, n=5; sarcoma, n=5; and ovarian cancer, n=4) experienced FN. Serious complications were documented in 10 of the patients. Twenty-eight of the 72 patients (38.9%) were classified as high-risk cases according to the MASCC score. The sensitivity, specificity, and area under receiver operating characteristic (ROC) curve of the MASCC score for predicting serious complications were 60%, 69%, and 0.63, respectively. Sixteen of the 72 patients (22%) were classified as high-risk cases according to the CISNE score. The sensitivity, specificity, and area under ROC curve for predicting serious complications were 40%, 82%, and 0.48, respectively. Conclusion. The CISNE score was not as useful as the MASCC score for predicting serious complications. We should develop a superior prediction model for use in Japan