Acute Lymphoblastic Leukemia (ALL) — Stem Cell Transplant: Treatment in the Best Hospitals in the World
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Department of Hematology and Bone Marrow Transplantation
The Department of Hematology and Bone Marrow Transplantation offers the full range of medical services for patients with benign and malignant diseases of the blood and hematopoietic system. In addition, the department is the leading highly specialized Turkish medical facility in the field of bone marrow transplantation. This procedure is indicated for patients with leukemia, lymphoma, multiple myeloma and aplastic anemia. The Section for Bone Marrow Transplantation meets all the current standards of modern medicine, as well as the criteria of the European JACIE organization, which accredits hospitals specializing in this procedure. The patients with blood malignancies receive the most effective chemotherapy regimens, which allow the doctors to achieve brilliant therapeutic results even in especially complex clinical cases. The department's doctors also successfully perform apheresis procedures.
Department of Hematology, Oncology, Rheumatology, Infectology and Bone Marrow Transplantation
The Department of Hematology, Oncology, Rheumatology, Infectology and Bone Marrow Transplantation offers modern diagnostics and treatment in all areas of its specialization. The medical facility treats patients with solid malignant tumors of various locations, malignant and benign diseases of the hematopoietic system, rheumatic diseases, and infections. The department enjoys a reputation as one of the leading health facilities for bone marrow transplants in Germany, which is confirmed by accreditation in accordance with JACIE standards. More than 80 allogeneic and more than 100 autologous bone marrow transplants are performed in the medical facility annually. In addition, the department successfully carries out innovative CAR T-cell therapy, which is available only in the most advanced medical centers worldwide. The department is part of the Comprehensive Cancer Center Ulm (CCCU), where a multidisciplinary team of highly professional doctors takes care of the health of patients. The high quality of medical services is confirmed by the certification of the German Cancer Society (DKG). The health of patients is in the safe hands of experienced specialists who strive to provide each patient with the most effective treatment using advanced therapeutic methods. The medical facility has 112 beds and many specialized outpatient clinics.
Department of Hematology and Oncology
The Department of Hematology and Oncology offers the full range of diagnostics and treatment of blood diseases, coagulation disorders, oncological diseases and related pathological conditions. The treatment is provided both on an outpatient and inpatient basis. The patient is offered a comprehensive treatment, including intensive care to eliminate side effects associated with the tumor and therapy, development of individual recommendations on nutrition, physiotherapeutic measures and psycho-oncological care.
Department of Hematology, Oncology, Hemostaseology, Rheumatology and Infectology
The Department of Hematology, Oncology, Hemostaseology, Rheumatology and Infectology offers the full range of medical services in the fields of its specialization. The department specializes in the diagnostics and treatment of all diseases of the hematopoietic system, systemic treatment of solid tumors, infectious diseases, including outpatient admission of patients with HIV, blood clotting disorders, as well as the entire clinical and morphological group of rheumatic diseases. The department is actively engaged in research activities and regularly implements the latest medical developments into clinical practice, thereby providing treatment in accordance with the most advanced scientific achievements.
Department of Hematology, Oncology, Adult and Pediatric Rheumatology
The Department of Hematology, Oncology, Adult and Pediatric Rheumatology offers the full range of modern diagnostics and treatment of malignant diseases, rheumatic pathologies, including particularly complex clinical cases in these fields. In addition, the department's doctors specialize in stem cell transplantation and occupy leading positions in this field at the international level. The medical team of the department makes every effort to guarantee each patient an individual, first-class treatment, based on the very latest achievements of modern medicine and human respect, understanding of the needs of each patient.
Department of Oncology and Hematology
The Department of Oncology and Hematology offers accurate diagnostics and effective treatment of benign and malignant blood diseases, as well as solid tumors. The department's specialists are proud of the excellent results in the field of bone marrow transplantation, which is among the department’s priority focuses. The department has 61 beds. Medical care is carried out both on an outpatient and inpatient basis.
Department of Gastroenterology, Hematology, Oncology, Hepatology, Infectology, Rheumatology and Clinical Immunology
The Department of Gastroenterology, Hematology, Oncology, Hepatology, Infectology, Rheumatology and Clinical Immunology offers the full range of diagnostics and treatment in these fields. The department specializes in the treatment of benign and malignant diseases of the digestive system, liver and bile ducts, the hematopoietic system, etc. Much attention is paid to the interdisciplinary cooperation (Cancer Center Mainfranken, etc.).
Charité Comprehensive Cancer Center
Charité Comprehensive Cancer Center offers patients the full range of classical and innovative examinations, treatment of malignant diseases of all organs and anatomical structures of the human body. The spectrum is complemented by follow-up medical care, rehabilitation, modern schemes for the prevention and early detection of malignant diseases. An important component of the therapeutic process in the center is psycho-oncological care. The centerdals with the treatment of patients of all age groups, ranging from small children to elderly patients.
Department of Hematology and Oncology
The Department of Hematology and Oncology provides diagnostics and comprehensive treatment of diseases of the hematopoietic system, as well as solid tumors of various organs. Hematologists most often deal with the treatment of acute and chronic leukemias, malignant lymphomas, myelodysplastic syndromes, plasmacytomas and other pathologies. Chemotherapy is usually first-line therapy. The department's specialists also successfully perform bone marrow transplantation. In the field of oncology, the department provides effective treatment of various tumors of the gastrointestinal tract, endocrine glands, female and male reproductive system, skin cancer, soft tissue and bone sarcomas, head and neck malignancies, etc. The patients suffering from cancer are offered classical (chemotherapy, immunotherapy, hormone therapy) and innovative (immunotherapy, CAR T-cell therapy) treatment methods. Surgical resection of solid tumors is performed by specialized surgeons. The treatment regimen is developed individually for each patient at the tumor board, which plays an important role in achieving a successful treatment result.
Department of Hematology, Oncology and Pulmonology
According to the Focus magazine, the Department of Hematology, Oncology and Pulmonology ranks among the top medical facilities in Germany specializing in bowel cancer treatment! The department offers the full range of modern diagnostics and treatment of solid tumors, benign and malignant blood and hematopoietic system diseases, including bleeding disorders, as well as pathologies of the lungs and other organs of the respiratory system. The offer is complemented by effective palliative care. All physicians of the department are highly qualified experts in their area of specialization and apply theoretical knowledge and clinical experience to ensure an optimal therapy result.
Department of Hematology and Oncology
The Department of Hematology and Oncology offers comprehensive diagnosis and effective treatment of the entire spectrum of oncological diseases of the hematopoietic system, benign blood disorders, and solid malignancies of various localizations. The primary specialization in the department is blood cancer treatment. The department's doctors have in their arsenal many methods with scientifically proven effectiveness in the fight against cancer: chemotherapy, targeted therapy, antibody therapy, hormone therapy, immunotherapy, as well as stem cell transplantation and innovative CAR T-cell therapy. Treatment tactics are developed taking into account the individual needs and wishes of each patient, thanks to which specialists manage to achieve good results. The department also offers maintenance therapy to alleviate the side effects of the basic course of cancer treatment and palliative care. The department has the status of a Leukemia and Lymphoma Center certified by the German Cancer Society (DKG). In addition, it is one of the few centers in Europe certified according to JACIE standards in the field of bone marrow transplantation. Competent physicians with in-depth knowledge and extensive clinical experience in their specialty care for the health of the patients.
Department of Oncology, Hematology, Rheumatology and Immunoncology
The Department of Oncology, Hematology, Rheumatology and Immunoncology offers the full range of diagnostics and treatment of solid tumors, benign and malignant diseases of blood and bone marrow, rheumatic pathologies. The priority purpose of each employee in the department is to provide patients with an optimal medical care, based on the use of the very latest treatment methods. The department's specialists are distinguished by their high professionalism and colossal experience in the treatment of extremely complex clinical cases.
Department of Oncology, Hematology and Palliative Care
The Department of Oncology, Hematology and Palliative Care offers all the options of modern medicine for the treatment of patients with the pathologies in these fields. Specialization covers the treatment of cancer of the internal organs, blood cancer, symptomatic treatment of progressive incurable diseases. Other focuses of the department are intensive care medicine and special pain therapy. To achieve successful and long-term results, the clinical practice is based on the use of effective classic and innovative treatment methods.
Department of Oncology, Hematology and Bone Marrow Transplantation
The Department of Oncology, Hematology and Bone Marrow Transplantation provides the full range of diagnostic and therapeutic services to patients with malignant solid tumors, and benign and malignant blood pathologies. Of particular interest is the treatment of patients with acute leukemia, lymphomas, multiple myeloma, sarcomas, gastrointestinal cancer, lung cancer, breast cancer, and rare malignant tumors. The department is part of the Comprehensive Cancer Center Munich, thanks to which doctors from related specialties are involved in the therapeutic process. All modern diagnostic methods and therapeutic procedures are available here, including bone marrow transplantation, which is often the most effective treatment method for blood cancer. The health of patients is in the safe hands of a highly qualified medical team, consisting of 65 doctors and 130 nurses. The department treats about 2,800 inpatients and more than 10,000 outpatients every year. The department's specialists pay due attention to the psychological state of their patients diagnosed with cancer, so a program of psycho-oncological care is being successfully implemented here.
Department of Hematology, Hemostaseology, Oncology and Pulmonology
The Department of Hematology, Hemostaseology, Oncology and Pulmonology offers the full range of diagnostics and treatment of blood diseases, including oncopathologies and blood coagulation disorders, lung diseases, and rare malignant diseases. The department incorporates two modern Bone Marrow Transplantation Centers. In addition, the department belongs to the largest medical facilities in Germany, which specialize in the treatment of malignant lymphomas, acute leukemias, sarcomas, as well as bone marrow transplantation. The physicians of the department are committed to providing patients with the comprehensive medical care of the highest quality, based on the respective attitude towards patients.
Department of Hematology, Oncology and Immunology
According to the Focus magazine, the Department of Hematology, Oncology and Immunology ranks among the top German medical facilities specializing in leukemia treatment! The department offers accurate diagnostics and effective treatment of malignant and benign blood diseases, solid tumors. The patients are treated in close collaboration with the Comprehensive Cancer Center. Of particular interest to the department's doctors is the treatment of various types of leukemia (within the specialized center with advanced infrastructure). The department takes part in many national and international clinical trials, which makes it possible for patients with advanced stages of cancer to receive treatment using innovative therapeutic methods.
Stem cell transplantation is a procedure for the treatment of acute lymphoblastic leukemia. It is more effective than chemotherapy, but more expensive and more often causes side effects. It is used in extreme cases when it is impossible to cope with the disease in other ways. The doctors mainly apply donor stem cells. They are obtained from bone marrow or peripheral blood.
Why is the stem cell transplantation carried out?
Bone marrow transplantation is rarely applied for the treatment of acute lymphoblastic leukemia in adults. It is mostly carried out for the treatment of acute lymphoblastic leukemia in children. It increases the chances to cure the disease completely. Stem cell transplantation is carried out at the stage of consolidation – when the remission of the disease is achieved.
Acute lymphoblastic leukemia can be successfully treated by means of chemotherapy, but the problem is that too high doses of drugs cannot be applied. They damage bone marrow and impair the haematopoiesis. If standard doses are applied, not all malignant cells may die. As a result, some children may have relapses.
Stem cell transplantation is an option for the treatment of acute lymphoblastic leukemia in children, in which the doctor can apply high-dose therapy. Although it destroys patient's own bone marrow, it will be transplanted and haematopoiesis function will be restored.
Indications
Stem cell transplantation can be indicated for the child in the following cases:
- risk of relapse after chemotherapy is rated as high;
- initially poor response to chemotherapy;
- early relapse after achieving a remission;
- severe types of T-cell leukemia;
- Philadelphia chromosome leukemia.
Stem cell transplantation is usually not carried out if a relapse occurs later than 6 months after the chemotherapy completion. In this case, the repeated course of drug administration is very likely to be successful.
Allogeneic transplantation
Bone marrow transplantation in leukemia is mostly carried out from another person – from a donor. It is better if a person is a brother or sister of the child. Families do not always have other children. In addition, if they are, they do not always have sufficient tissue compatibility. If appropriate donor among close people is not found, he will be searched in the donor database by the HLA compatibility. The higher it is, the greater the chances of successful procedure. In case of insufficient compatibility, graft versus host disease may occur, which ends with the death of the patient.
Nowadays, in many countries, the doctors freeze umbilical cord blood after childbirth. It persists for a long time and can be used as a source of stem cells for allogeneic transplantation, including in the case of acute lymphoblastic leukemia, but the number of cells is small. Their amount can be sufficient for a child, but not for an adult patient.
Autologous transplantation
Occasionally, the patient himself may be the source of stem cells, but such approach has less chances of success. After all, his own tissues are affected by the tumor process. Sometimes the doctors manage to obtain the bone marrow without malignant cells. The implantation may be carried out after additional processing.
Autologous transplantation is safer, but less effective. Although this type of bone marrow transplantation does not produce graft versus host diseases, it also does not initiate graft versus tumor effect. Therefore, the chances of complete cure are lower, they depend solely on whether the cancer is completely destroyed during high-dose chemotherapy. The patient receives drugs not only before, but also after transplantation.
Is stem cell transplantation dangerous?
Stem cell transplantation is dangerous for a child. For this reason, the doctors perform it only in extreme cases when it is impossible to cure leukemia in other ways.
Allogeneic transplantation carries three great dangers, but the possibility of one of them is very low, almost zero. These include:
- Cells will not survive. They will be destroyed by the recipient's body before their number becomes sufficient for the normalization of hematopoietic function.
- Graft versus host disease. New cells can attack healthy ones. Sometimes this reaction proceeds in a mild form, but the severe cases are also possible. The result is the death of the patient.
- There is a theoretical possibility of transplantation of stem cells, which are affected by parenteral infection. In developed countries, such cases are practically excluded.
Stem cell transplantation from a relative is less risky than from a another donor.
In addition, the number of the following complications can be caused by high-dose chemotherapy:
- During the first 6 weeks after transplantation, the blood practically does not contain leukocytes. Therefore, the risk of infectious complications is possible. After this critical period, the risk of infections begins to decline. The immune system is completely restored only after 6-12 months.
- Hemorrhages are possible due to the decreased number of platelets. They are most likely during the first 3 weeks. The problem can be solved by means of transfusion of platelet mass. Therefore, severe hemorrhages usually do not occur. The case is limited to bleeding gums and slight bruising on the skin.
- Interstitial pneumonitis. This is inflammatory condition of the lungs. In contrast to pneumonia, it has a non-infectious origin. The pathology can be caused by chemotherapy and manifests itself as connective tissue inflammation. The occurrence of this complication is most likely during the first 100 days, the possibility persists up to 2 years after transplantation.
To avoid complications, the doctors carefully monitor the patient's condition and the symptoms. They regularly perform tests and chest X-ray.
If allogeneic stem cell transplantation is successful, it usually cures the disease. Relapses are sometimes possible, but they occur much less frequently than after chemotherapy alone.
Treatment abroad with the Booking Health company
To undergo treatment of acute lymphoblastic leukemia abroad, you can use the services of the Booking Health company. You will get the following benefits:
- We will study your medical history and select the best clinic where you will be most likely to successfully treat acute lymphoblastic leukemia.
- Reduced cost of bone marrow transplant in Germany due to the absence of overpricing and additional coefficients for foreign patients.
- Booking an appointment for bone marrow transplantation on the most suitable dates for you.
- Preparation of the diagnostic and treatment program taking into account previously performed examinations.
- Establishment of communication directly with your attending physician.
- Monitoring of the program at all its stages.
- Control of invoices, return of unspent funds upon the diagnostics and treatment completion.
- Buying and forwarding of medicines.
- Organization of additional diagnostics or treatment.
- Communication with the clinic upon completion of the diagnostics and treatment of acute lymphoblastic leukemia abroad.
The Booking Health company will provide you with top-class services. We will book a hotel and airline tickets, help you to prepare the documents, meet you at the airport and take you to the medical facility.
