Name of the Procedure:

• Common Name: Azacitidine Injection
• Technical Term: Injection, azacitidine, 1 mg (HCPCS Code: J9025)

Summary

Azacitidine injection is a medical procedure where a small amount of the chemotherapy drug azacitidine is administered to treat certain blood and bone marrow cancers. The medication helps reduce abnormal cell growth and promotes the production of healthy blood cells.

Purpose

Azacitidine injections are primarily used to:

• Treat myelodysplastic syndromes (MDS).
• Manage certain types of leukemia, specifically acute myeloid leukemia (AML).

The goal is to slow the progression of the disease, improve blood cell counts, and alleviate symptoms associated with the condition.

Indications

This procedure is indicated for patients experiencing:

• Low blood cell counts (anemia, neutropenia, thrombocytopenia).
• Myelodysplastic syndromes (MDS), including refractory anemia.
• Chronic myelomonocytic leukemia (CMML).
• Acute myeloid leukemia (AML) with a high percentage of immature blood cells.

Preparation

Patients may need to:

• Undergo blood tests and other diagnostic assessments to determine baseline health.
• Discuss medication regimens with their healthcare provider to manage potential interactions.
• Follow specific instructions regarding food and fluid intake before the procedure.

Procedure Description

1. Location Preparation: The procedure typically takes place in an oncology clinic or hospital outpatient department.
2. Patient Positioning: The patient is seated comfortably or lying down.
3. Injection Site: A healthcare professional identifies an appropriate site, usually the upper arm, thigh, or abdomen.
4. Cleaning and Preparation: The skin at the injection site is cleaned with an antiseptic.
5. Injection: Using a sterile syringe and needle, the correct dose of azacitidine is injected subcutaneously (under the skin) or intravenously (into a vein), depending on the prescribed administration route.
6. Post-Injection: The site is cleaned and bandaged if necessary.

Duration

Each injection typically takes about 10-20 minutes. Treatment cycles usually repeat every 4 weeks and may include multiple injections over 7 days.

Setting

Azacitidine injections are typically administered in:

• Hospitals
• Outpatient Oncology Clinics
• Specialized Treatment Centers

Personnel

• Oncologist or Hematologist
• Registered Nurses or Nurse Practitioners
• Medical Assistants

Risks and Complications

Common risks may include:

• Injection site reactions (redness, swelling, pain)
• Nausea or vomiting
• Fatigue
• Fever

Less common but serious risks:

• Severe infection due to lowered white blood cell count
• Uncontrolled bleeding due to low platelets
• Severe allergic reaction (anaphylaxis)

Benefits

• Slow disease progression.
• Improve blood cell counts.
• Enhanced quality of life by reducing disease symptoms.

Patients may start noticing improvements within a few weeks after beginning treatment.

Recovery

Post-procedure care involves:

• Monitoring for side effects and managing symptoms.
• Regular follow-up appointments.
• Blood tests to monitor cell counts.

Recovery time varies; many patients can resume normal activities shortly after each injection, but some may need to adjust activities based on how they feel.

Alternatives

Other treatment options include:

• Bone marrow transplant
• Other chemotherapy drugs
• Supportive care (e.g., blood transfusions)

Each alternative has its own benefits and risks, which should be discussed with a healthcare provider.

Patient Experience

During the procedure, patients may experience mild discomfort at the injection site. Post-procedure symptoms can include fatigue and flu-like symptoms. Pain management strategies and supportive care are available to help manage any side effects.