Name of the Procedure:

Common Names:

• Injection of Filgrastim
• G-CSF Injection

Technical/Medical Term:

• Injection, filgrastim (G-CSF), excludes biosimilars, 1 microgram (HCPCS Code: J1442)

Summary

Filgrastim injection is a medical procedure where a specific protein called granulocyte colony-stimulating factor (G-CSF) is administered to stimulate the production of white blood cells, which help the body fight infections.

Purpose

Medical Conditions Addressed:

• Neutropenia (low white blood cell count) often caused by chemotherapy, bone marrow transplantation, or other medical conditions.

Goals/Expected Outcomes:

• To increase the white blood cell count, thereby reducing the risk of infection in patients with weakened immune systems.

Indications

Symptoms/Conditions:

• Low white blood cell counts due to chemotherapy, radiation therapy, chronic neutropenia, or bone marrow transplants.

Patient Criteria:

• Patients undergoing chemotherapy or radiation therapy.
• Patients with chronic neutropenia.
• Patients who have received a bone marrow transplant.

Preparation

Pre-procedure Instructions:

• No specific fasting requirements.
• Inform the healthcare provider of any current medications.
• Routine blood tests to check the white blood cell count and overall health status.

Procedure Description

Step-by-step Explanation:

1. The healthcare provider will sanitize the injection site, typically on the abdomen or thigh.
2. Using a sterile syringe, a specific dose of filgrastim is drawn and injected subcutaneously (under the skin).

Tools & Equipment:

• Sterile syringe and needle.
• Antiseptic wipes or solution.
• Vial of filgrastim.

Anesthesia/Sedation:

• None required; local injection.

Duration

• The injection itself typically takes a few minutes to administer.

Setting

• Usually performed in a hospital, outpatient clinic, or at home under medical supervision.

Personnel

• Administered by a trained nurse or other healthcare professional.

Risks and Complications

Common Risks:

• Localized pain or discomfort at the injection site.

• Mild fever or flu-like symptoms.

  Rare Risks:

• Allergic reactions.
• Splenic rupture (very rare).

Possible Complications:

• In the rare event of severe side effects, treatment would include discontinuation and supportive care.

Benefits

Expected Benefits:

• Reduced risk of infection.
• Increased white blood cell count within a few days to a week.

Recovery

Post-procedure Care:

• Monitor the injection site for signs of infection.
• Report any unusual side effects to the healthcare provider.

Expected Recovery:

• No significant downtime; patients can usually resume their normal activities immediately.
• Follow-up blood tests may be required.

Alternatives

Other Treatment Options:

• Biosimilars of filgrastim (excluded in this context).
• Different types of G-CSF (e.g., pegfilgrastim).
• Antibiotics to prevent infections (without increasing white blood cell counts).

Pros and Cons of Alternatives:

• Biosimilars may offer similar efficacy at a potentially lower cost.
• Different G-CSFs might have different dosing schedules (e.g., longer-acting).

Patient Experience

During the Procedure:

• A brief stinging or burning sensation at the injection site.

After the Procedure:

• Minor soreness or redness at the injection site.
• Mild flu-like symptoms may occur but typically resolve quickly.
• Pain management includes over-the-counter pain relievers if necessary.