Question 1

Does the MASCC index apply to haematological malignancy patients?

Accepted Answer

Validated predominantly in solid tumours. Use with caution in acute leukaemia or transplant recipients where complication rates are higher regardless of score.

Question 2

What antibiotics are recommended for outpatient management of low-risk FN?

Accepted Answer

ESMO/NCCN: ciprofloxacin 750 mg BID + amoxicillin/clavulanate 875/125 mg BID for 5–7 days. Monotherapy with fluoroquinolone is not recommended.

Question 3

How does CISNE complement MASCC?

Accepted Answer

CISNE adds discrimination within MASCC low-risk. MASCC low-risk patients with CISNE ≥3 should not be managed as outpatients.

Question 4

When should the MASCC index be re-calculated?

Accepted Answer

At FN onset for initial triage. Re-check at 24 and 48 hours if outpatient. Worsening symptoms or instability warrant hospitalisation regardless of score.