Name of the Procedure

Injection, rituximab 10 mg and hyaluronidase

• Common Name: Rituximab Injection
• Medical Term: Rituximab and Hyaluronidase Injection, HCPCS Code J9311

Summary

This procedure involves injecting rituximab, a monoclonal antibody, along with hyaluronidase, an enzyme that aids in the absorption and dispersion of the medication. It is designed to treat certain types of cancers and autoimmune diseases by targeting and destroying specific cells.

Purpose

Medical Conditions:

• Non-Hodgkin’s lymphoma
• Chronic lymphocytic leukemia
• Rheumatoid arthritis
• Other autoimmune diseases and certain cancers

Goals/Outcomes:

• Decrease or eliminate cancerous cells
• Reduce symptoms and slow the progression of autoimmune diseases
• Improve patient’s quality of life

Indications

Symptoms/Conditions:

• Enlarged lymph nodes
• Fatigue and fever
• Swollen, painful joints (for autoimmune conditions)
• Abnormal blood cell counts

Patient Criteria:

• Diagnosis of specific types of lymphomas, leukemias, or autoimmune disorders
• Patients for whom other treatments have been ineffective or are not suitable

Preparation

Pre-Procedure Instructions:

• Fasting may not be required, but follow doctor’s instructions
• Adjustments to medications may be necessary
• Stay hydrated and report any allergies

Diagnostic Tests:

• Blood tests
• Imaging scans (e.g., CT, MRI)
• Physical examination

Procedure Description

1. Initial Preparation: Patient is positioned comfortably, and the skin at the injection site is cleansed.
2. Injection: Rituximab and hyaluronidase are injected subcutaneously, often in the abdomen or thigh.

3. Monitoring: Patient is monitored for any immediate adverse reactions.

   Tools/Equipment:

   • Syringe and needle
   • Antiseptic wipes

Anesthesia/Sedation:

• Typically, no anesthesia is required; a topical anesthetic may be used if necessary.

Duration

The actual injection takes a few minutes. Monitoring post-injection can take up to 1-2 hours.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or specialized treatment center.

Personnel

• Oncologist or specialist
• Nurse
• Pharmacist (for medication preparation)

Risks and Complications

Common Risks:

• Injection site reactions (redness, swelling)
• Mild fever or chills
• Temporary discomfort

Rare Complications:

• Severe allergic reactions (anaphylaxis)
• Infusion reactions (nausea, headache)
• Infection at injection site

Management:

• Immediate treatment with antihistamines or corticosteroids for allergic reactions
• Close monitoring and supportive care

Benefits

• Reduction or elimination of cancerous cells
• Alleviation of symptoms related to autoimmune diseases
• Improved daily functioning and overall quality of life
• Beneficial effects may be noticeable within weeks to months

Recovery

Post-Procedure Care:

• Observe injection site for signs of infection
• Follow prescribed medication regimen
• Stay hydrated and report any unusual symptoms

Recovery Time:

• Minimal downtime; patients can typically resume normal activities shortly after

Follow-Up Appointments:

• Regular follow-ups with the healthcare provider for monitoring and additional doses as necessary

Alternatives

Other Treatments:

• Oral medications
• Intravenous (IV) chemotherapy
• Radiation therapy
• Surgical interventions

Pros and Cons:

• Oral medications are less invasive but may be less effective in certain cases
• IV chemotherapy is highly effective but comes with more severe side effects
• Radiation therapy and surgery may be more localized but can have longer recovery times

Patient Experience

During Procedure:

• Mild discomfort or stinging at the injection site
• Some patients may feel apprehensive but are generally comfortable

After Procedure:

• Minor soreness or swelling at the site
• Possible flu-like symptoms temporarily
• Pain management with over-the-counter pain relievers if needed

Overall, the procedure is relatively straightforward with a quick recovery time and significant potential benefits for eligible patients.