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Treatment of acute myeloid leukemia (AML) with CAR T-cell therapy (program ID: 666058)

University Hospital Giessen UKGM

location_on Giessen, Germany
9.5/10 from 35 Votes
Specialized hospital
Friedrich Grimminger

Head Physician
Prof. Dr. Dr. med.

Friedrich Grimminger

Specialized in: oncology, hematology, palliative care

Department of Oncology, Hematology and Palliative Care

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, Hematology and Palliative Care at the University Hospital Giessen UKGM 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. The department is headed by Prof. Dr. Dr. med. Friedrich Grimminger.

The department's oncologists take care of the health of patients with malignant diseases of all organs. The department is part of the Interdisciplinary Cancer Center, within which all experts from related fields work for the benefit of patients. The individual and optimal treatment regimens are developed at interdisciplinary tumor boards. The treatment is carried out in accordance with national and international protocols of professional societies. The patients with terminal stages of the disease are provided with all the necessary palliative care measures, which helps to alleviate symptoms and improve the quality of life.

Another department’s priority is the treatment of patients with malignant diseases of the hematopoietic and lymphatic systems. Of particular interest is the treatment of malignant lymphomas, acute and chronic leukemias and myeloproliferative disorders. The spectrum is also complemented by therapy for blood-clotting disorders, such as immune thrombocytopenia.

The department's range of medical services includes:

  • Diagnostics and treatment of oncological diseases of internal organs
    • Respiratory system cancers
      • Lung cancer
      • Pleural cancer
    • Gastrointestinal cancers
      • Bowel cancer
      • Rectal cancer
      • Esophageal carcinoma
      • Stomach cancer
      • Pancreatic cancer
      • Liver cancer
    • Head and neck tumors 
      • Primary brain tumors
      • Tumors of the lips, mouth and oropharynx
      • Laryngeal cancer
      • Thyroid cancer
    • Gynecological tumors
      • Breast cancer
      • Ovarian cancer
      • Uterine cancer
      • Cervical cancer
    • Urological tumors
      • Prostate cancer
      • Kidney cancer
      • Bladder cancer
    • Rare tumors
      • Sarcomas
      • Melanomas
  • Diagnostics and treatment of hematological diseases
    • Acute lymphocytic leukemia
    • Acute myeloid leukemia
    • Amyloidosis
    • Aplastic anemia
    • Chronic lymphocytic leukemia
    • Chronic myeloid leukemia
    • Essential thrombocythemia
    • Hairy cell leukemia
    • Hemoglobinopathies
    • Hemolytic anemia
    • Hodgkin's lymphoma
    • Immune thrombocytopenia
    • Multiple myeloma
    • Myelodysplastic syndrome
    • Non-Hodgkin’s lymphoma
    • Polycythemia vera
    • Osteomyelosclerosis
  • Palliative care for patients at the terminal stage of cancer aimed at alleviating symptoms and improving quality of life
  • Other medical services

Curriculum vitae

Prof. Friedrich Grimminger studied medicine at the Justus Liebig University Giessen. He also completed a semester at the British Universities of Newcastle and Edinburgh (Chemistry and Biology). In 1989, he received his doctorate in Human Medicine, and in 1990 also received a diploma in Biology. Two years later, he had his habilitation in Human Medicine at the Justus Liebig University Giessen. In 1994, Prof. Grimminger had his board certification in Internal Medicine with a focus on Pulmonology, Oncology, Intensive Care, Palliative Care and Pain Therapy. He is a Honorary Professor at the Universities of Kent (Canterbury, UK) and Texas, USA.

Photo of the doctor: (c) UKGM - Universitätsklinikum Gießen und Marburg GmbH


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