Name of the Procedure:

Injection of rituximab and hyaluronidase (HCPCS code: C9467)

Summary

Rituximab and hyaluronidase injection is a treatment where medication is administered to target specific proteins on the surface of immune cells. This combination can help treat certain types of cancers and autoimmune diseases by slowing down or stopping the growth of harmful cells.

Purpose

The purpose of this injection is to treat conditions like non-Hodgkin's lymphoma, chronic lymphocytic leukemia, and some autoimmune diseases such as rheumatoid arthritis. The goal is to either reduce the size of cancer tumors or manage the symptoms of autoimmune disorders to improve the patient's quality of life.

Indications

• Non-Hodgkin's lymphoma
• Chronic lymphocytic leukemia
• Rheumatoid arthritis
• Other autoimmune diseases as advised by a healthcare professional

Preparation

• Patients may need to fast for a few hours before the procedure.
• Inform your doctor about any medications you are currently taking; adjustments might be necessary.
• Diagnostic tests like blood work may be required beforehand to assess your eligibility and ensure your safety during the procedure.

Procedure Description

1. The patient is positioned comfortably, usually seated or lying down.
2. A healthcare professional cleans the injection site with antiseptic.
3. Rituximab and hyaluronidase are prepared and loaded into a syringe.
4. The injection is administered subcutaneously (under the skin) or intravenously, depending on the specific medical instructions.
5. The patient is monitored for a short period post-injection for any immediate adverse reactions.

Duration

The entire procedure typically takes about 30 minutes to an hour, including preparation and post-injection monitoring.

Setting

This procedure is usually performed in an outpatient clinic, hospital, or specialized medical center.

Personnel

• Oncologist or rheumatologist (depending on the condition being treated)
• Registered nurse or medical assistant
• Anesthesiologist, if sedation is required

Risks and Complications

• Common risks: mild pain or swelling at the injection site, rash, fever, nausea.
• Rare but serious risks: severe allergic reactions, infections, low blood pressure, heart problems.
• Complications are managed by administering supportive treatments and monitoring the patient closely.

Benefits

• Reduction in tumor size for cancer patients.
• Improvement in symptoms and quality of life for patients with autoimmune diseases.
• Effects can be seen within weeks, though response time varies among individuals.

Recovery

• Patients can usually go home the same day.
• Avoid strenuous activity for 24 hours post-procedure.
• Follow-up appointments will be scheduled to monitor the treatment's effectiveness and manage any side effects.
• Patients should report any unusual symptoms to their healthcare provider right away.

Alternatives

• Other forms of chemotherapy or immunotherapy.
• Radiation therapy for cancer patients.
• Different medications or biologics for managing autoimmune diseases.
• Each alternative has its own pros and cons, which should be discussed with a healthcare professional.

Patient Experience

• During the procedure, patients might experience mild discomfort or a stinging sensation at the injection site.
• Post-procedure, there can be some localized pain or swelling which is usually manageable with over-the-counter pain relievers.
• The healthcare team will provide comfort measures and pain management strategies as needed.