Patients with any of the following characteristics are considered to be at high risk for serious complications during episodes of neutropenic fever: |
Receipt of cytotoxic therapy sufficiently myelosuppressive to result in anticipated severe neutropenia (ANC <500 cells/mcL) for >7 days* |
MASCC risk index score <21Δ |
CISNE score of ≥3Δ (in patients with solid tumors) |
Presence of any active uncontrolled comorbid medical problems, including, but not limited to: - Signs of severe sepsis or septic shock (eg, hemodynamic instability, mental status changes of new onset, respiratory dysfunction, oliguria)
- Oral or gastrointestinal mucositis that interferes with swallowing or causes severe diarrhea
- Gastrointestinal symptoms, including abdominal pain, nausea and vomiting, or diarrhea
- Intravascular catheter infection, especially catheter tunnel infection
- New pulmonary infiltrate or hypoxemia
- Underlying chronic lung disease
- Complex infection at the time of presentation
|
Alemtuzumab or CAR-T cell use within the past two months |
Uncontrolled or progressive cancer¶ |
Evidence of hepatic insufficiency (defined as aminotransferase levels >5 times normal values) or renal insufficiency (defined as a creatinine clearance of <30 mL/minute) |