Name of the Procedure:

Injection, gemtuzumab ozogamicin, 0.1 mg (HCPCS Code: J9203)

Summary

Gemtuzumab ozogamicin is a chemotherapeutic drug used to treat certain types of leukemia. The procedure involves injecting a small dose of this medication directly into the bloodstream to target and kill cancer cells.

Purpose

This procedure primarily addresses acute myeloid leukemia (AML). The goal is to reduce or eliminate cancer cells, potentially leading to remission.

Indications

• Diagnosed with CD33-positive acute myeloid leukemia (AML).
• Patients in first relapse or whose leukemia is resistant to initial treatment.
• May be used in combination with other chemotherapeutic agents as part of a larger treatment protocol.

Preparation

• Patients may need to undergo blood tests and imaging studies to evaluate their overall health and specific condition.
• Fasting might be required if the procedure integrates with other treatments.
• Consultation with a healthcare provider about current medications, as adjustments may be necessary.

Procedure Description

1. The patient is positioned comfortably, typically in a reclining chair or hospital bed.
2. An intravenous (IV) line is inserted into a vein, usually in the arm.
3. Pre-medications may be administered to reduce the risk of side effects.
4. Gemtuzumab ozogamicin is slowly infused through the IV over a period of time, under the supervision of healthcare professionals.
5. The IV line is removed once the infusion is complete. Tools & Equipment: IV line, infusion pump, gemtuzumab ozogamicin vials. Anesthesia/Sedation: Typically not required, but anti-nausea medications may be given.

Duration

The infusion process generally takes about 2 to 4 hours.

Setting

The procedure is typically performed in a hospital oncology unit or an outpatient clinic specialized in chemotherapy.

Personnel

• Oncologist or hematologist
• Chemotherapy-certified nurse
• Pharmacist for medication preparation
• Support staff for patient care

Risks and Complications

Common Risks:

• Nausea and vomiting
• Fatigue
• Fever Rare Risks:
• Severe allergic reactions
• Liver damage
• Increased risk of infection due to low blood cell counts Complications such as infection or bleeding will be managed with supportive care and medications as needed.

Benefits

• Targeted destruction of leukemia cells with the potential to achieve remission.
• Benefits can be realized within weeks, though multiple treatment rounds may be needed.

Recovery

• Patients are generally monitored for a few hours post-infusion for any immediate reactions.
• Instructions include hydration, rest, and managing side effects.
• Follow-up appointments to monitor blood counts and disease progression.

Alternatives

• Traditional chemotherapy regimens.
• Bone marrow or stem cell transplants.
• Pros and cons: Alternatives may vary in effectiveness and side effect profiles. Bone marrow transplants, for instance, have a more extended recovery period but offer a chance for long-term remission.

Patient Experience

Patients might feel a range of emotions and physical sensations such as anxiety, slight discomfort at the IV site, or fatigue. Pain management and anti-nausea medications are provided to enhance comfort. It's important to communicate openly with healthcare providers about any concerns or side effects experienced during and after the procedure.