Name of the Procedure:

Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine (J9153)

Summary

This procedure involves administrating a liposomal injection that combines two chemotherapy drugs, daunorubicin and cytarabine. These drugs are encapsulated in liposomes to improve their delivery and effectiveness against leukemia.

Purpose

This injection is primarily used to treat adults with newly diagnosed acute myeloid leukemia (AML) that arises from prior chemotherapy or exposure to radiation. The goal is to destroy cancerous cells, induce remission, and improve survival rates.

Indications

• Newly diagnosed acute myeloid leukemia (AML)
• AML arising from prior chemotherapy or radiation
• Patients who require targeted cytotoxic therapy with reduced systemic side effects

Preparation

• Discuss any medications you are currently taking with your healthcare provider.
• Pre-procedure blood tests to assess your general health and liver/kidney function.
• Fasting for a specific period may be required, as advised by your healthcare provider.
• Provide a complete medical history, including any allergies or previous adverse reactions to chemotherapy.

Procedure Description

1. Consultation and Consent: Initial meeting with the oncologist to discuss the treatment plan and obtain informed consent.
2. Preparation: The patient is settled in a comfortable setting, typically an outpatient clinic.
3. Injection: The nurse or oncologist administers the liposomal injection intravenously, usually through a central venous catheter.
4. Monitoring: Patient is monitored for any immediate adverse reactions or side effects.

Duration

The injection process typically takes about 1-2 hours, including preparation and post-injection monitoring.

Setting

The procedure is usually performed in an outpatient oncology clinic or a hospital infusion center.

Personnel

• Oncologist or Hematologist
• Registered Nurse specialized in chemotherapy administration
• Pharmacist for drug preparation
• Support staff for monitoring

Risks and Complications

• Common: Nausea, vomiting, fatigue, fever, infection risk, hair loss, mouth sores.
• Rare: Severe allergic reactions, heart toxicity, liver or kidney impairment, severe infections due to immunosuppression.

Benefits

• Targeted destruction of leukemia cells.
• Improved remission rates and potential for prolonged survival.
• Reduced systemic side effects due to liposomal encapsulation.

Recovery

• Monitor for side effects and manage symptoms with medications as prescribed.
• Maintain regular follow-up visits with your oncologist for blood tests and health assessments.
• Avoid strenuous activities as advised, and eat a balanced diet to aid recovery.
• Report any unusual symptoms to your healthcare provider promptly.

Alternatives

• Traditional chemotherapy without liposomal delivery.
• Bone marrow transplant.

• Targeted therapies or immunotherapies.

  Pros of Alternatives:

  • May be more effective in certain patient populations.
  • Different side effect profiles.

Cons of Alternatives:

• Higher systemic side effects with traditional chemotherapy.
• Limited availability or suitability of bone marrow transplants.

Patient Experience

• During the injection: Mild discomfort or pain at the injection site, potential for minor nausea or allergic reactions.
• Post-procedure: Fatigue and other common chemotherapy-related side effects. Pain management includes prescribed medications and supportive care.
• Comfort measures: Hydration, anti-nausea medications, rest, and a supportive care system.