Carmona-Bayonas et al developed the Clinical Index of Stable Febrile Neutropenia (CISNE) to evaluate patients with stable neutropenia following chemotherapy for solid tumors. This can help to identify a patient who is at increased risk for serious complications. The authors are from multiple institutions in Spain and Chile.
Patient selection: adult with febrile neutropenia after chemotherapy of mild to moderate intensity, clinically stable
Febrile neutropenia: fever >= 38°C, absolute neutrophil count <= 500 per µL (or <= 1,000 per µL but expected to be <= 500 per µL)
Time period for stability: first 3 hours after onset of febrile neutropenia
Status: no evidence of organ failure, no sepsis or septic shock, no known severe infections, no other serious complications
Outcomes: shock, organ failure, death
Parameters:
(1) ECOG performance status
(2) stress-induced hyperglycemia
(3) COPD
(4) chronic cardiovascular disease
(5) mucositis
(6) absolute monocyte count
|
Parameter |
Finding |
Points |
|
ECOG performance status |
0 or 1 |
0 |
|
|
2, 3 or 4 |
2 |
|
stress-induced hyperglycemia |
no |
0 |
|
|
yes |
2 |
|
COPD |
no |
0 |
|
|
yes |
1 |
|
chronic cardiovascular disease |
no |
0 |
|
|
yes |
1 |
|
mucositis |
none or Grade 1 |
0 |
|
|
Grade 2, 3 or 4 |
1 |
|
absolute monocyte count |
>= 200 per microliter |
0 |
|
|
< 200 per microliter |
1 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the greater the risk of serious complications.
|
Total Score |
Risk |
|
0 |
low |
|
1 or 2 |
intermediate |
|
3 to 8 |
high |
Performance:
• The score was validated at multiple cancer centers.
Purpose: To evaluate an adult cancer patient with febrile neutropenia after chemotherapy for a solid tumor using the CISNE score of Carmona-Bayonas et al.
Specialty: Infectious Diseases, Hematology Oncology
Objective: severity, prognosis, stage, response to therapy
ICD-10: C00-C14, C15-C26, C30-C39, C40-C41, C43-C44, C45-C49, C50-C50, C51-C58, C60-C63, C64-C68, C69-C72, C73-C75, C76-C80, C81-C96, C97-C97, D70,
