Prospective Evaluation of Multinational Association of Supportive Care in Cancer Risk Index Score for Gynecologic Oncology Patients with Febrile Neutropenia

Camille C. Gunderson, Britt K. Erickson, Ivy Wilkinson-Ryan, Sara K. Vesely, Charles A. Leath, Paola A. Gehrig, Kathleen N. Moore

Research output: Contribution to journalArticle

Abstract

Background: The Multinational Association of Supportive Care of Cancer (MASCC) risk-index score has been validated as a stratification tool for febrile neutropenia (FN) risk in a heterogeneous group of cancer patients; recently, it has been deemed a suitable tool in gynecologic oncology patients in a retrospective study. This is a prospective multi-institutional study wherein we sought to validate MASCC score for stratifying FN morbidity in gynecologic oncology patients. Methods: IRB approval was obtained at 4 institutions for prospective data collection of gynecologic cancer patients admitted with FN from 3/1/2013 to 9/1/2014. Participating institutions have a policy of inpatient management of FN patients receiving chemotherapy. Deidentified data was compiled and processed at the leading institution. Results: In total, 31 patients met inclusion criteria. Most had advanced stage disease (67%). 100% of patients were receiving chemotherapy (57% for primary, 43% for recurrent disease). 55% had a positive culture. Median MASCC score was 21 (range, 10 to 26); 58% of patients were considered low risk. High risk patients more often had one (11% vs. 38%, P=0.09) or multiple (6% vs. 23%, P=0.28) severe complications, ICU admission (0% vs. 15%, P=0.17), and delay in next chemotherapy cycle (33% vs. 54%, P=0.25). No patients died from FN during the study period. Conclusions: This pilot data suggests that MASCC score may be a promising tool for determining suitability of outpatient management of FN in gynecologic oncology patients. Larger studies are warranted to achieve statistically significant results, which may enable us to effectively utilize this risk stratification tool for cost containment and avoidance of nosocomial infections.

Original languageEnglish (US)
Pages (from-to)138-142
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume42
Issue number2
DOIs
StatePublished - Feb 1 2019
Externally publishedYes

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Febrile Neutropenia
Neoplasms
Drug Therapy
Cost Control
Research Ethics Committees
Cross Infection
Inpatients
Outpatients
Retrospective Studies

Keywords

  • MASCC
  • chemotherapy complications
  • febrile neutropenia
  • gynecologic cancer
  • multinational association of supportive care in cancer

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study
  • Research Support, N.I.H., Extramural

Cite this

Prospective Evaluation of Multinational Association of Supportive Care in Cancer Risk Index Score for Gynecologic Oncology Patients with Febrile Neutropenia. / Gunderson, Camille C.; Erickson, Britt K.; Wilkinson-Ryan, Ivy; Vesely, Sara K.; Leath, Charles A.; Gehrig, Paola A.; Moore, Kathleen N.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 42, No. 2, 01.02.2019, p. 138-142.

Research output: Contribution to journalArticle

Gunderson, Camille C. ; Erickson, Britt K. ; Wilkinson-Ryan, Ivy ; Vesely, Sara K. ; Leath, Charles A. ; Gehrig, Paola A. ; Moore, Kathleen N. / Prospective Evaluation of Multinational Association of Supportive Care in Cancer Risk Index Score for Gynecologic Oncology Patients with Febrile Neutropenia. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2019 ; Vol. 42, No. 2. pp. 138-142.
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abstract = "Background: The Multinational Association of Supportive Care of Cancer (MASCC) risk-index score has been validated as a stratification tool for febrile neutropenia (FN) risk in a heterogeneous group of cancer patients; recently, it has been deemed a suitable tool in gynecologic oncology patients in a retrospective study. This is a prospective multi-institutional study wherein we sought to validate MASCC score for stratifying FN morbidity in gynecologic oncology patients. Methods: IRB approval was obtained at 4 institutions for prospective data collection of gynecologic cancer patients admitted with FN from 3/1/2013 to 9/1/2014. Participating institutions have a policy of inpatient management of FN patients receiving chemotherapy. Deidentified data was compiled and processed at the leading institution. Results: In total, 31 patients met inclusion criteria. Most had advanced stage disease (67{\%}). 100{\%} of patients were receiving chemotherapy (57{\%} for primary, 43{\%} for recurrent disease). 55{\%} had a positive culture. Median MASCC score was 21 (range, 10 to 26); 58{\%} of patients were considered low risk. High risk patients more often had one (11{\%} vs. 38{\%}, P=0.09) or multiple (6{\%} vs. 23{\%}, P=0.28) severe complications, ICU admission (0{\%} vs. 15{\%}, P=0.17), and delay in next chemotherapy cycle (33{\%} vs. 54{\%}, P=0.25). No patients died from FN during the study period. Conclusions: This pilot data suggests that MASCC score may be a promising tool for determining suitability of outpatient management of FN in gynecologic oncology patients. Larger studies are warranted to achieve statistically significant results, which may enable us to effectively utilize this risk stratification tool for cost containment and avoidance of nosocomial infections.",
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AU - Gunderson, Camille C.

AU - Erickson, Britt K.

AU - Wilkinson-Ryan, Ivy

AU - Vesely, Sara K.

AU - Leath, Charles A.

AU - Gehrig, Paola A.

AU - Moore, Kathleen N.

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N2 - Background: The Multinational Association of Supportive Care of Cancer (MASCC) risk-index score has been validated as a stratification tool for febrile neutropenia (FN) risk in a heterogeneous group of cancer patients; recently, it has been deemed a suitable tool in gynecologic oncology patients in a retrospective study. This is a prospective multi-institutional study wherein we sought to validate MASCC score for stratifying FN morbidity in gynecologic oncology patients. Methods: IRB approval was obtained at 4 institutions for prospective data collection of gynecologic cancer patients admitted with FN from 3/1/2013 to 9/1/2014. Participating institutions have a policy of inpatient management of FN patients receiving chemotherapy. Deidentified data was compiled and processed at the leading institution. Results: In total, 31 patients met inclusion criteria. Most had advanced stage disease (67%). 100% of patients were receiving chemotherapy (57% for primary, 43% for recurrent disease). 55% had a positive culture. Median MASCC score was 21 (range, 10 to 26); 58% of patients were considered low risk. High risk patients more often had one (11% vs. 38%, P=0.09) or multiple (6% vs. 23%, P=0.28) severe complications, ICU admission (0% vs. 15%, P=0.17), and delay in next chemotherapy cycle (33% vs. 54%, P=0.25). No patients died from FN during the study period. Conclusions: This pilot data suggests that MASCC score may be a promising tool for determining suitability of outpatient management of FN in gynecologic oncology patients. Larger studies are warranted to achieve statistically significant results, which may enable us to effectively utilize this risk stratification tool for cost containment and avoidance of nosocomial infections.

AB - Background: The Multinational Association of Supportive Care of Cancer (MASCC) risk-index score has been validated as a stratification tool for febrile neutropenia (FN) risk in a heterogeneous group of cancer patients; recently, it has been deemed a suitable tool in gynecologic oncology patients in a retrospective study. This is a prospective multi-institutional study wherein we sought to validate MASCC score for stratifying FN morbidity in gynecologic oncology patients. Methods: IRB approval was obtained at 4 institutions for prospective data collection of gynecologic cancer patients admitted with FN from 3/1/2013 to 9/1/2014. Participating institutions have a policy of inpatient management of FN patients receiving chemotherapy. Deidentified data was compiled and processed at the leading institution. Results: In total, 31 patients met inclusion criteria. Most had advanced stage disease (67%). 100% of patients were receiving chemotherapy (57% for primary, 43% for recurrent disease). 55% had a positive culture. Median MASCC score was 21 (range, 10 to 26); 58% of patients were considered low risk. High risk patients more often had one (11% vs. 38%, P=0.09) or multiple (6% vs. 23%, P=0.28) severe complications, ICU admission (0% vs. 15%, P=0.17), and delay in next chemotherapy cycle (33% vs. 54%, P=0.25). No patients died from FN during the study period. Conclusions: This pilot data suggests that MASCC score may be a promising tool for determining suitability of outpatient management of FN in gynecologic oncology patients. Larger studies are warranted to achieve statistically significant results, which may enable us to effectively utilize this risk stratification tool for cost containment and avoidance of nosocomial infections.

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