title: Prognostic evaluation of febrile neutropenia in apparently stable adult cancer patients.
abstract: `
  
  
  BACKGROUND
  Predictive models to identify low-risk febrile neutropenia (FN) have been developed with heterogeneous samples, which included stable and unstable patients, solid tumours, acute leukaemia and bone marrow transplantation. These models fail to recognise 5-15% of cases with unexpected complications, and literature specifically addressing apparently stable patients (ASPs) is scarce.
  
  
  METHODS
  We reviewed 861 episodes of FN in outpatients with solid tumours, including 692 (80%) episodes with apparent clinical stability. We aimed to investigate the prognosis of this latter group and explore the possibility of stratifying it according to the presenting features. A case-control study was performed and the MASCC index was evaluated.
  
  
  RESULTS
  The rates of complications and bacteraemia in ASPs were 7.3% and 6.2%, respectively. The MASCC index yielded a low sensitivity to detect complications (36%). Prognostic factors were identified: ECOG performance status ≥2, chronic bronchitis, chronic heart failure, stomatitis NCI grade ≥2, monocytes <200 mm(-3) and stress hyperglycaemia.
  
  
  CONCLUSIONS
  A very simple assessment is useful to classify the patients with FN according to the risk of complications. A few additional variables may predict the clinical course of the patients. We additionally show that the MASCC index applied to this specific group has a low sensitivity to predict complications.
authors.affiliation: Department of Haematology and Medical Oncology, University Hospital Morales Meseguer, Avda Marqués de los Vélez, S/n 30001, Murcia, Spain. alberto.carmonabayonas@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Carmona-Bayonas
authors.forename: J
authors.initials: J
authors.lastname: Gómez
authors.forename: E
authors.initials: E
authors.lastname: González-Billalabeitia
authors.forename: M
authors.initials: M
authors.lastname: Canteras
authors.forename: A
authors.initials: A
authors.lastname: Navarrete
authors.forename: M L
authors.initials: ML
authors.lastname: Gonzálvez
authors.forename: V
authors.initials: V
authors.lastname: Vicente
authors.forename: F
authors.initials: F
authors.lastname: Ayala de la Peña
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D005334:Fever / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis*; D009503:Neutropenia / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult