Name of the Procedure:

Injection, tbo-filgrastim, 1 microgram (HCPCS Code: J1447)

• Common Names: Tbo-filgrastim Injection
• Technical Terms: Granulocyte Colony-Stimulating Factor (G-CSF) Injection

Summary

Tbo-filgrastim injection is a medical procedure that involves administering a medication known as tbo-filgrastim, which helps stimulate the production of white blood cells. This is often used in patients undergoing treatments that reduce white blood cell counts, such as chemotherapy.

Purpose

Tbo-filgrastim is used to:

• Increase white blood cell counts in patients undergoing chemotherapy.
• Reduce the risk of infection due to low white blood cell counts.
• Accelerate recovery from neutropenia (low levels of a specific type of white blood cell called neutrophils).

Indications

The procedure is indicated for:

• Patients undergoing chemotherapy that suppresses bone marrow function.
• Individuals with severe chronic neutropenia.
• Patients who have undergone a bone marrow transplant.

Preparation

Patients may need to:

• Undergo blood tests to determine current white blood cell levels.
• Consult with their healthcare provider about any medications they are taking.
• Follow specific dietary instructions if advised by their healthcare provider.

Procedure Description

• The healthcare provider will sanitize the injection site, usually the upper arm, thigh, or abdomen.
• Tbo-filgrastim is administered as a subcutaneous injection (under the skin).
• The procedure involves using a small needle and syringe to inject the medication.
• The patient may feel a slight pinch or pressure during the injection.
• Anesthesia or sedation is typically not required for this procedure.

Duration

The injection process itself usually takes only a few minutes.

Setting

The procedure is typically performed in:

• Hospital outpatient clinics.
• Oncology centers.
• Outpatient medical offices.

Personnel

The procedure is often performed by:

• Registered nurses.
• Physician assistants.
• Oncologists or hematologists overseeing the treatment plan.

Risks and Complications

Common risks include:

• Redness or swelling at the injection site.
• Bone or muscle pain.
• Slight fever.

Rare but potential complications:

• Allergic reactions.
• Spleen enlargement or rupture.
• Respiratory distress.

Most side effects are manageable with over-the-counter medications and monitoring by healthcare professionals.

Benefits

• Rapid increase in white blood cell counts.
• Reduced risk of severe infections.
• Speedier recovery from neutropenia. Benefits are usually noticed within a few days of the injection.

Recovery

• Patients can generally resume normal activities shortly after the injection.
• Slight soreness at the injection site may be experienced.
• Follow-up appointments may be necessary to monitor white blood cell counts and overall health.

Alternatives

• Other G-CSF medications like filgrastim or pegfilgrastim.
• Antibiotic prophylaxis to prevent infections.
• Dose adjustments in chemotherapy regimens to minimize bone marrow suppression. Pros and cons should be discussed with the healthcare provider to determine the best option.

Patient Experience

During the procedure, patients might feel:

• A brief pinch or discomfort at the injection site.
• Mild soreness or redness afterward, which typically resolves within a day or two.

Pain management:

• Over-the-counter pain relief like ibuprofen or acetaminophen may be recommended if needed.