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Treatment of acute myeloid leukemia (AML) with CAR T-cell therapy (program ID: 665977)

University Hospital Marburg UKGM

location_on Marburg, Germany
8.6/10 from 18 Votes
Specialized hospital
Andreas Neubauer

Head Physician
Prof. Dr. med.

Andreas Neubauer

Specialized in: hematology, oncology, immunology

Department of Hematology, Oncology and Immunology

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

According to the Focus magazine, the Department of Hematology, Oncology and Immunology at the University Hospital Marburg UKGM 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.

The department is headed by Prof. Dr. med. Andreas Neubauer. The doctor has a unique competence in the field of his specialization and regularly ranks among the top German doctors (according to the Focus magazine)!

The department has vast experience in the treatment of patients with chemotherapeutic drugs. Chemotherapy is carried out on an outpatient basis, so the patient can return home after it. The therapeutic offer is supplemented by other treatment methods, for example, red blood cell and platelet transfusion, immunoglobulin infusions, antibody immunotherapy, pleural puncture and laparocentesis. One of the important components of therapy is psycho-oncological care. The specialists help patients to cope with a diagnosis and to cheer up for a positive therapy outcome.

The department also specializes in bone marrow transplantation, which is most often used in malignant diseases of the hematopoietic (for example, leukemia) and lymphatic systems (for example, malignant lymphoma). The department performs about 20 allogeneic and more than 30 autologous transplantations every year. In addition, it applies new transplantation methods, which allow to increase its efficiency. The clinical activities in this field are certified in accordance with the requirements of JACIE (Joint Accreditation Committee ISCT-Europe & EBMT) and the European Society for Blood and Marrow Transplantation (EBMT), which guarantees the best possible safety and treatment effectiveness.

The main focuses of the department's clinical practice include: 

  • Diagnostics and treatment of blood cancer (leukemia and malignant lymphomas)
  • Diagnostics and treatment of germ-cell tumors (for example, testicular cancer)
  • Diagnostics and treatment of malignant tumors of the gastrointestinal tract
  • Diagnostics and treatment of connective tissue tumors
  • Diagnostics and treatment of tumors of the respiratory system 
  • Diagnostics and treatment of head and neck tumors
  • Diagnostics and treatment of blood-clotting disorders
  • Chemotherapy (on an outpatient basis)
  • Allogeneic and autologous bone marrow transplantation, including patient care before and after transplantation
  • Special hematological diagnostics
  • Diagnostics and treatment of congenital and acquired immunodeficiencies
  • Other diagnostic and therapeutic options

Curriculum vitae

Education

  • 10.1976 - 05.1983 Study of Human Medicine in Berlin and Hamburg.
  • 1984 Doctoral thesis defense at the University of Hamburg.
  • 1992 Habilitation, Internal Medicine, Free University of Berlin.

Scientific and Clinical Activities

  • 2010 Invitation to the position of W3 Professor, University of Freiburg (refusal).
  • 2004 Invitation to the position of C4 Professor, University of Würzburg (refusal).
  • Since 1999 C4 Professor, Philipps University of Marburg.
  • 10.1996 - 12.1998 C3 Professor, Technical University of Dresden.
  • 10.1990 - 09.1996 Assistant Physician (since 1993 Senior Physician), Department of Hematology and Oncology, Charlottenburg Hospital, Free University of Berlin.
  • 10.1988 - 09.1990 Postdoctoral Scholarship, German Research Foundation, Comprehensive Cancer Center Lineberger, University of North Carolina at Chapel Hill, North Carolina, USA.
  • 03.1986 - 09.1988 Assistant Physician, Department of Hematology and Oncology, Charlottenburg Hospital, Free University of Berlin.
  • 09.1985 - 02.1986 Postdoctoral Scholarship, German Research Foundation, Max Planck Institute of Biochemistry, Martinsried.
  • 07.1984 - 08.1985 Assistant Physician, Department of Hematology and Oncology, Charlottenburg Hospital, Free University of Berlin.
  • 07.1983 - 06.1984 Assistant Physician, Department of Nephrology, Charlottenburg Hospital, Free University of Berlin.

Research Focuses

  • Genetic examination in myeloid leukemia.
  • Molecular biology of tumor resistance.
  • Role of Helicobacter pylori infection in the development of gastric lymphoma.

Prizes and Honors

  • 2016 Behring-Röntgen Medal (for Research Activities).
  • 2008 Hessian State Prize (Third Place) for Oncology Curriculum.
  • 2006 Wilhelm Warner Award for Cancer Research.

Memberships in Professional Societies

  • 01.1988 German Society for Hematology and Medical Oncology.
  • 05.1989 American Association for the Advancement of Science.
  • 01.1991 Cancer and Leukemia Group B.
  • 01.1994 American Society of Hematology.
  • 05.1994 German Cancer Society.
  • 05.1994 European Hematology Association.
  • 10.1994 Berlin Cancer Society.
  • 10.1994 German Working Group on Gene Therapy.
  • 04.1998 German Society of Internal Medicine.
  • 01.1999 American Society of Clinical Oncology.
  • 10.1997 Scientific Advisory Board of the German Society of Hematology and Medical Oncology.
  • Scientific Committee of the Josep Carreras Leukaemia Foundation.

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


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