Treatment of acute myeloid leukemia (AML) with CAR T-cell therapy
University Hospital RWTH Aachen
Aachen, Germany
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Initial presentation at the clinic. The doctor collects the patient's medical history, looks at his medical records and previous examinations. Special attention is paid to previous cancer treatments and their results, since CAR T-cell therapy is indicated only if the conventional treatment protocols are ineffective. Based on the results of the consultation, the doctor administers the examination, which includes a complete blood count with white blood cell count, assessment of liver and kidney function, immunohistochemical and genetic analysis of tumor cells (if indicated) and other studies.<\/p>\n\n<p><strong>Day 3<\/strong>. Collecting patient’s blood. During the leukapheresis procedure, doctors harvest at least 100 million T-cells, which will subsequently undergo gene modification. If there are certain clinical reasons, and the patient needs to postpone the subsequent stages of CAR T-cell therapy, the harvested T-cells undergo the procedure of cryoconservation. If the patient is able to continue treatment immediately, then the harvested T-cells are transferred to the laboratory.<\/p>\n\n<p><strong>Days 4-12<\/strong>. Processing and gene modification of the T-cells pool lasts 7-10 days. During this time, the patient is receiving immunosuppressive chemotherapy drugs. The chemotherapy is aimed at suppressing the patient's own immune system, which will allow CAR T-cells to fight the tumor more effectively.<\/p>\n\n<p><strong>Day 13<\/strong>. Manufactured CAR T-cells are tested for the microbiological safety and functional activity. After the successful testing completion, the solution with CAR T-cells is administered to the patient intravenously.<\/p>\n\n<p><strong>Day 14 and other days<\/strong>. Control examination and further medical supervision in the hospital are carried out. If there are no side effects of CAR T-cell therapy, a stable tendency towards normalization of blood count is observed and the patient has stable general health condition, the patient is discharged from the hospital. Before the discharge, the patient receives the detailed recommendations for further follow-up during the disease remission.<\/p>\n<\/div><div class=\"program_required_documents mt-4\"><h4>Required documents<\/h4><ul>\n\t<li>Complete blood count with white blood cell count<\/li>\n\t<li>Biochemical blood test (renal and liver function tests), if available<\/li>\n\t<li>Bone marrow biopsy results<\/li>\n\t<li>CT scan, if available<\/li>\n<\/ul>\n<\/div>","program_full_story_crm":"<ul>\n\t<li>Initial presentation in the clinic<\/li>\n\t<li>Clinical history taking<\/li>\n\t<li>Physical examination<\/li>\n\t<li>Review of medical records<\/li>\n\t<li>Laboratory tests:\n\t<ul>\n\t\t<li>Complete blood count<\/li>\n\t\t<li>General urine analysis<\/li>\n\t\t<li>Biochemical blood test (kidney and liver function tests)<\/li>\n\t\t<li>Indicators of inflammation (CRP, ESR)<\/li>\n\t\t<li>Indicators of blood coagulation<\/li>\n\t\t<li>Immunohistochemical and genetic analysis of tumor cells (if indicated)<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>Leukapheresis, processing of T-cells and cultivation of CAR T-cells<\/li>\n\t<li>Adjuvant chemotherapy<\/li>\n\t<li>Infusion of modified CAR T-cells to a patient<\/li>\n\t<li>Control examinations<\/li>\n\t<li>Cost of essential medicines and materials<\/li>\n\t<li>Nursing services<\/li>\n\t<li>Full hospital accommodation<\/li>\n\t<li>Explanation of future recommendations<\/li>\n<\/ul>\n<div class=\"program_indications_for_surgery\"><h4>Indications<\/h4><ul>\n\t<li>Acute myeloid leukemia (AML) that is resistant to the conventional therapy<\/li>\n<\/ul>\n<\/div><div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p><strong>Days 1-2<\/strong>. Initial presentation at the clinic. The doctor collects the patient's medical history, looks at his medical records and previous examinations. Special attention is paid to previous cancer treatments and their results, since CAR T-cell therapy is indicated only if the conventional treatment protocols are ineffective. Based on the results of the consultation, the doctor administers the examination, which includes a complete blood count with white blood cell count, assessment of liver and kidney function, immunohistochemical and genetic analysis of tumor cells (if indicated) and other studies.<\/p>\n\n<p><strong>Day 3<\/strong>. Collecting patient’s blood. During the leukapheresis procedure, doctors harvest at least 100 million T-cells, which will subsequently undergo gene modification. If there are certain clinical reasons, and the patient needs to postpone the subsequent stages of CAR T-cell therapy, the harvested T-cells undergo the procedure of cryoconservation. If the patient is able to continue treatment immediately, then the harvested T-cells are transferred to the laboratory.<\/p>\n\n<p><strong>Days 4-12<\/strong>. Processing and gene modification of the T-cells pool lasts 7-10 days. During this time, the patient is receiving immunosuppressive chemotherapy drugs. The chemotherapy is aimed at suppressing the patient's own immune system, which will allow CAR T-cells to fight the tumor more effectively.<\/p>\n\n<p><strong>Day 13<\/strong>. Manufactured CAR T-cells are tested for the microbiological safety and functional activity. After the successful testing completion, the solution with CAR T-cells is administered to the patient intravenously.<\/p>\n\n<p><strong>Day 14 and other days<\/strong>. Control examination and further medical supervision in the hospital are carried out. If there are no side effects of CAR T-cell therapy, a stable tendency towards normalization of blood count is observed and the patient has stable general health condition, the patient is discharged from the hospital. 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Program id #
666007
PD Dr. med. Edgar Jost
Department of Oncology and Hematology
Specialized in: oncology, hematology The program includes:
- Initial presentation in the clinic
- Clinical history taking
- Physical examination
- Review of medical records
- Laboratory tests:
- Complete blood count
- General urine analysis
- Biochemical blood test (kidney and liver function tests)
- Indicators of inflammation (CRP, ESR)
- Indicators of blood coagulation
- Immunohistochemical and genetic analysis of tumor cells (if indicated)
- Leukapheresis, processing of T-cells and cultivation of CAR T-cells
- Adjuvant chemotherapy
- Infusion of modified CAR T-cells to a patient
- Control examinations
- Cost of essential medicines and materials
- Nursing services
- Full hospital accommodation
- Explanation of future recommendations
Indications
- Acute myeloid leukemia (AML) that is resistant to the conventional therapy
How program is carried out
Days 1-2. Initial presentation at the clinic. The doctor collects the patient's medical history, looks at his medical records and previous examinations. Special attention is paid to previous cancer treatments and their results, since CAR T-cell therapy is indicated only if the conventional treatment protocols are ineffective. Based on the results of the consultation, the doctor administers the examination, which includes a complete blood count with white blood cell count, assessment of liver and kidney function, immunohistochemical and genetic analysis of tumor cells (if indicated) and other studies.
Day 3. Collecting patient’s blood. During the leukapheresis procedure, doctors harvest at least 100 million T-cells, which will subsequently undergo gene modification. If there are certain clinical reasons, and the patient needs to postpone the subsequent stages of CAR T-cell therapy, the harvested T-cells undergo the procedure of cryoconservation. If the patient is able to continue treatment immediately, then the harvested T-cells are transferred to the laboratory.
Days 4-12. Processing and gene modification of the T-cells pool lasts 7-10 days. During this time, the patient is receiving immunosuppressive chemotherapy drugs. The chemotherapy is aimed at suppressing the patient's own immune system, which will allow CAR T-cells to fight the tumor more effectively.
Day 13. Manufactured CAR T-cells are tested for the microbiological safety and functional activity. After the successful testing completion, the solution with CAR T-cells is administered to the patient intravenously.
Day 14 and other days. Control examination and further medical supervision in the hospital are carried out. If there are no side effects of CAR T-cell therapy, a stable tendency towards normalization of blood count is observed and the patient has stable general health condition, the patient is discharged from the hospital. Before the discharge, the patient receives the detailed recommendations for further follow-up during the disease remission.
Required documents
- Complete blood count with white blood cell count
- Biochemical blood test (renal and liver function tests), if available
- Bone marrow biopsy results
- CT scan, if available
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About the department
The Department of Oncology and Hematology at the University Hospital RWTH Aachen 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. The department is headed by PD Dr. med. Edgar Jost.
The department specializes in the diagnostics and treatment of leukemias and lymphomas, as well as aplastic syndromes, mast cell diseases and myeloproliferative neoplasms. The priorities of inpatient medical care are the treatment of acute leukemias and high-dose chemotherapy. In the field of solid tumor treatment, the department is known for systemic therapy of lung cancer, head and neck tumors, sarcomas, etc. In addition, the standard services include supportive treatment and systematic psycho-oncological consultations.
The department cooperates closely with the Euregional Comprehensive Cancer Center Aachen. Therefore, the department has an access to the very latest diagnostic and treatment methods, as well as the opportunity to engage all the necessary specialists to the treatment process. The therapy of cancers requires particularly professional and comprehensive approach, and therefore the treatment strategy for each patient is developed individually with the participation of oncologists, radiologists, radiation therapists, specialized doctors (for example, otolaryngologists, orthopedists), etc. The psycho-oncological care also plays an important role in the treatment process, since when the patients hear the diagnosis of cancer, they often lose heart and cannot cope with an emotional stress on their own. If desired, the treatment within the clinical trials is possible.
The department provides the diagnostics and treatment of the following pathologies:
- Myelodysplastic syndrome
- Acute myeloid leukemias
- Chronic myeloid leukemias
- Aplastic syndromes (for example, aplastic anemia, paroxysmal nocturnal hemoglobinuria)
- Hereditary and acquired anemias
- Blood clotting disorders
- Multiple myeloma
- Myeloproliferative neoplasms (for example, essential thrombocythemia, true polycythemia, primary myelofibrosis)
- Brain tumors
- Lymphomas of the central nervous system
- Head and neck tumors
- Lung cancer
- Lymphomas
- Melanomas (choroidal, metastatic melanomas)
- Other diseases
Photo of the doctor: (c) Uniklinik RWTH Aachen
About hospital
According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals!
As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the accurate diagnostics, effective therapy and productive research activities within one specialized center.
The hospital has more than 60 departments, institutes and interdisciplinary centers. A competent team of professionals, consisting of more than 7,000 employees (more than 940 doctors, including about 95 professors), takes care of the patients' health. In addition, multidisciplinary teams of nurses, physiotherapists, as well as medical and technical staff are available here. The patients and respectful attitude to their social, cultural and religious affiliations are at the center of all employees' efforts.
The cornerstone of the successful clinical practice is the innovative technical base. The hospital offers the most advanced diagnostic and therapeutic equipment. Thus, the hospital has all the resources in order to provide top-class medical services.
Photo: (с) depositphotos
Accommodation in hospital
Patients rooms
The patients of the University Hospital RWTH Aachen live in comfortable single and double rooms. All patient rooms are designed with large windows, so one can enjoy a beautiful landscape view. Each patient room has an ensuite bathroom. The standard room furnishing includes an automatically adjustable bed, a bedside table, a spacious wardrobe, a TV, a radio and a telephone. Also, there is Wi-Fi access.
Meals and Menus
The patient and his accompanying person have a daily choice of three menus. If for any reason you do not eat all the foods, you will be offered an individual menu. Please inform the medical staff about your dietary preferences prior to the treatment.
Further details
Standard rooms include:
Toilet
Shower
Wi-Fi
TV
Religion
Religious services are available upon request.
Accompanying person
During the inpatient program, an accompanying person may stay with you in a patient room or at the hotel of your choice.
Hotel
During the outpatient program, you can live at a hotel of your choice. Managers will help you to choose the most suitable options.
The hospital offers a full range of laboratory tests (general, hormonal, tests for infections, antibodies, tumor markers, etc.), genetic tests, various modifications of ultrasound scans, CT scans, MRI and PET / CT, angiography, myelography, biopsy and other examinations. Treatment with medications, endoscopic and robotic operations, stereotaxic interventions is carried out here, modern types of radiation therapy are also used. The hospital offers patients all the necessary therapeutic techniques.
- Embolization of tumors and vascular malformations
- Aortic surgery, including in children
- Radiosurgical interventions in the head and body region
- Cochlear implantation
- Treatment of all types of sports injuries
These are pathologies of the brain and spinal cord, benign and malignant tumors of various localizations, congenital and acquired heart defects, joint pathologies, stroke, neurodegenerative diseases, eye injuries, inflammatory skin diseases, allergies and other pathologies.
- Oncology (EU Regional Center for Comprehensive Cancer Care Aachen)
- Pediatric cardiac surgery
- General and abdominal surgery
- Plastic and burn surgery
- Pediatric and adolescent medicine
Over 940 highly qualified doctors work at the hospital.