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 journalArticlepeer-review

2 Scopus citations

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

Bibliographical note

Funding Information:
From the *Department of Obstetrics and Gynecology, Section of Gyneco-logic Oncology; §Department of Biostatistics and Epidemiology, Uni-versity of Oklahoma Health Sciences Center, Oklahoma City, OK; †Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Alabama at Birmingham, Birmingham, AL; ‡Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University in St. Louis, St. Louis, MO; and ∥Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of North Carolina, Chapel Hill, NC. Support was provided in part by NIH to CAL 5K12HD0012580-14. The authors declare no conflicts of interest. Reprints: Camille C. Gunderson, MD, MS, 800 NE 10th Street, Suite 5050, Oklahoma City, OK 73104. E-mail: camille-gunderson@ouhsc.edu. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0277-3732/19/4202-0138 DOI: 10.1097/COC.0000000000000498

Keywords

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

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