Assessment and comparison of CISNE model versus MASCC model in clinically stable febrile neutropenia patients

Abstract

Background: Patients with chronic or resolved hepatitis B virus (HBV) infection have a risk of reactivation after chemotherapy. Japanese guidelines recommend that all patients on chemotherapy should be screened for HBV infection. Although Asian peoples are considered to be a high risk population of HBV infection, little is known about the screening rate in Japan. Methods: We analyzed health insurance claims data linked with hospital-based cancer registry. Patients diagnosed with cancer in 2014, 20 years and older, who received at least one dose of systemic anticancer therapy in 2014-15 entered the analyses. We assessed the HBV screening rates by HBsAg or anti-HBc test ordered around initial treatment, HBV-DNA test and entecavir prescription. A multiple logistic regression model was used to identify factors related to the receipt of screening. Results: Of 177636 patients (mean [SD] age, 65.6 [12.2] years), 82.6%, 12.9%, 4.5% patients had solid tumor other than hepatocellular carcinoma (HCC), hematologic malignancy and HCC, respectively. Among them, 88.5%, 8.8%, 2.6% patients received cytotoxic chemotherapy, targeted therapy and anti-CD20 antibody, respectively. Overall, 70.6% of patients were screened but 34.5% were tested HBsAg only. The positive predictors of the HBV screening were hematologic malignancy (OR 2.45; 95%CI, 2.35-2.55) and negative predictors were age 85 (OR 0.75 compared to age <65, 95%CI, 0.71-0.80), age 75-84 (OR 0.77; 95%CI, 0.75-0.79), targeted therapy (OR 0.79; 95%CI, 0.76-0.82). Among the screened patients, 13.2% were tested HBV-DNA and 1.49% were prescribed prophylactic entecavir. Conclusions: This is the largest study to evaluate the HBV screening rate before systemic anticancer therapy in Japan. Although the screening rate is higher than previous reports from other countries (13-19%), half of the screened patients were tested HBsAg only. The elderly patients and patients who received targeted therapy were less screened. Legal entity responsible for the study: Takahiro Higashi. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest. 421O Assessment and comparison of CISNE model versus MASCC model in clinically stable febrile neutropenia patients

Evaluation of the clinical Index of Stable febrile neutropenia risk stratification system for management of febrile neutropenia in gynecologic oncology patients

“…While ASCO includes both MASCC and CISNE cut-off 2 in its guidelines, we obtained the highest specificity (93.3%) and PPV (92.9%) by instead combining MASCC with CISNE cut-off 1. The performance characteristics that we report for both the CISNE score cut-offs and the MASCC score are similar to those previously reported in the literature in non-gynecologic populations ( Carmona-Bayonas et al, 2015 , Zheng et al, 2020 , Moon et al, 2018 , Ahn et al, 2018 , Koppaka et al, 2018 ).…”

Comparison of CISNE and MASCC Score in Predicting Complications on Post Chemotherapy Febrile Neutropenia

“…Two previous studies have analyzed the performance of CISNE scores in patients with solid malignancies. Research by Koppaka et al [11] also showed that CISNE scores had an AUROC of 0.846, whereas in Moon et al [7], CISNE scores had an AUROC of only 0.66. In our study, the population of solid malignancies was dominated by headneck malignancies, whereas previous studies showed head-neck malignancies in only 5% of populations.…”

“…67 (39,88) 26 (15,48) 20 (11,9) 24 (14,29) 11 (6,55) 20 (11,9) Chemotherapy The CISNE scores effectively predicted febrile neutropenia complications resulting from chemotherapy treatment of a solid malignancy with an AUROC of 0.893 (CI 95% 0.829-0.95; p = 0.03), whereas the MASCC scores with an AUROC of 0.77 (CI 95% 0.68-0.86; p = 0,04). Therefore, CISNE scores were found to be signi cantly better at predicting complications than MASCC scores in solid malignancy.…”

“…This study was the rst study to assess CISNE and MASCC score performance based on malignancy type. Previous studies by Koppaka et al [11] and Moon et al [7] were only conducted on patients with solid malignancy. Other research by Bayonas et al [2] was conducted on patients with solid malignancy in 90% of cases.…”

The role of serum albumin/globulin ratio in combination with prognostic risk indexes of febrile neutropenia

“…10 There are also a limited number of studies comparing MASCC and CISNE scores, and there is no clear consensus on the usage of these scores. [11][12][13] In these studies, the superiority of the CISNE score to the MASCC score was not clearly demonstrated and thus the improvement of these scoring systems is needed for a more accurate risk stratification. 7,11 Albumin and globulin are the main proteins in serum.…”