Injection, Plerixafor, 1 mg (J2562)

Name of the Procedure:

• Common Name: Plerixafor Injection
• Technical/Medical Term: Injection, plerixafor, 1 mg (HCPCS Code J2562)

Summary

Plerixafor injection is a medical procedure used to mobilize hematopoietic stem cells to the bloodstream, making it easier to harvest them for transplantation. This is commonly done in preparation for a stem cell transplant.

Purpose

• Medical Conditions: This procedure is primarily used for patients with certain types of cancers, such as non-Hodgkin lymphoma and multiple myeloma.
• Goals: The main goal is to increase the number of stem cells in the bloodstream to ensure successful harvesting and subsequent transplantation.

Indications

• Patients diagnosed with non-Hodgkin lymphoma or multiple myeloma.
• Candidates for autologous stem cell transplantation who may not achieve sufficient stem cell mobilization with standard methods alone.

Preparation

• Pre-Procedure Instructions: Patients should follow specific instructions related to their overall medical condition, including any adjustments to their current medications.
• Diagnostic Tests: Blood tests and other evaluations to determine the patient's eligibility and readiness for the procedure.

Procedure Description

1. Initial Blood Test: To determine basal levels of stem cells.
2. Injection: Plerixafor is administered subcutaneously, usually in combination with granulocyte-colony stimulating factor (G-CSF).
3. Monitoring: Throughout the process, blood counts are monitored to check the mobilization of stem cells.
4. Harvesting: Once adequate mobilization is achieved, stem cells are collected using apheresis.

• Tools/Equipment: Syringe for injection, apheresis machine for harvesting.
• Anesthesia/Sedation: Not typically required for the injection itself; the apheresis process may use light sedation if needed.

Duration

• The injection process takes only a few minutes.
• Overall mobilization and harvesting can take several days, spanning over multiple sessions.

Setting

• Typically performed in a hospital or specialized outpatient clinic.

Personnel

• Healthcare Professionals: Oncologist/hematologist, nurses, and apheresis technicians.

Risks and Complications

• Common Risks: Injection site reactions, nausea, diarrhea, dizziness, and fatigue.
• Rare Risks: Severe allergic reactions and low blood pressure. Management includes supportive care and discontinuation if severe reactions occur.

Benefits

• Expected Benefits: Enhanced stem cell mobilization, increasing the likelihood of a successful stem cell harvest.
• Realization Time: Mobilization is typically observed within a few hours to days after the injection.

Recovery

• Post-Procedure Care: Patients are usually monitored for side effects and overall health status.
• Recovery Time: Recovery is generally quick, but the overall process of mobilization and collection can take several days.
• Restrictions/Follow-up: Follow-up appointments to assess stem cell count and overall health.

Alternatives

• Other Options: Use of G-CSF alone for stem cell mobilization, or other pharmacologic agents.
• Pros and Cons: Plerixafor is particularly useful in patients who do not respond adequately to G-CSF alone, but it may not be necessary in all cases and carries additional risks and costs.

Patient Experience

• During the Procedure: Mild discomfort or pain at the injection site.
• After the Procedure: Possible side effects such as nausea or dizziness, which are typically mild and temporary. Pain management measures include over-the-counter analgesics if needed.