Treatment of acute myeloid leukemia (AML) with CAR T-cell therapy (program ID: 666085)
University Hospital Hamburg-Eppendorf
Carsten BokemeyerSpecialized in: hematology, oncology, pulmonology
Department of Hematology, Oncology and Pulmonology
- 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
- 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.
- 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 Pulmonology at the University Hospital Hamburg-Eppendorf 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. The department is headed by Prof. Dr. med. Carsten Bokemeyer.
In the field of hematology and oncology, of particular interest is the diagnostics and treatment of blood cancer (leukemias), lymphomas, gonadal tumors (for example, testicular cancer), malignancies of the digestive system, such as esophageal, stomach, pancreatic and colon cancer, cancer of the respiratory tract (lung cancer), connective tissue (sarcoma), as well as bleeding disorders. The pulmonary spectrum covers all diagnostic options, including interventional endoscopy and therapy. There is a unique experience in the treatment of pulmonary hypertension, cystic fibrosis, interstitial lung diseases.
An integral part of the department’s work is interdisciplinary cooperation with related doctors, such as radiologists, surgeons, radiation therapists, otolaryngologists, dermatologists, etc. An important role is also played by cooperation with all partners in the University Cancer Center Hamburg, as well as with international partners.
The department specializes in the diagnostics and treatment of the following diseases:
- Biliopancreatic tumors
- Lymphomas of the central nervous system
- Gastrointestinal tumors
- Brain tumors
- Testicular tumors
- Head and neck tumors
- Kidney cancer
- Prostate cancer
- Acute myeloid leukemia
- Chronic lymphocytic leukemia
- Chronic myeloid leukemia
- Myeloproliferative neoplasia
- Blood clotting disorders
- Myelodysplastic syndrome
- Paroxysmal nocturnal hemoglobinuria
- Lung cancer
- Pulmonary hypertension
- Interstitial lung diseases
- Pulmonary vascular diseases
- Mediastinal diseases
- Respiratory diseases
- Pleural diseases
- Pulmonary endoscopy
- Bronchoscopy (for diagnostic and therapeutic purposes)
- Pulmonary function testing
- Capillary blood gas test
- Body plethysmography
- Use of bronchodilators
- Bronchial provocation test
- Evaluation of lung diffusing capacity
- Spiroergometry with the possibility of non-invasive heart rate monitoring
- 6-min walk test
- Sleep screening
- Pulmonary endoscopy
- Diagnostics and treatment of other diseases
- 1989 Doctor of Medicine, Hannover Medical School, Hannover, Germany.
- 1989 FMGEMS.
- 1989 - 1995 Internship, Internal Medicine, Hannover Medical School, Hannover, Germany.
- 1995 - 2004 Faculty Member, Department of Internal Medicine, Section of of Hematology, Oncology, Immunology, Rheumatology, University Hospital Tuebingen, Germany.
Academic Appointments and Achievements
- 1999 Habilitation, Department of Internal Medicine, Hannover Medical School, Germany.
- 2000 Nominated for C3 Professorship of Internal Medicine at the University of Muenster, Germany.
- 2000 Associate Professor of Internal Medicine, University of Tuebingen.
- 2004 Professor of Internal Medicine and Head of the Department of Hematology, Oncology and Pulmonology at the University Hospital Hamburg-Eppendorf.
- 2007 Director of the University Cancer Center Hamburg.
- 1993 Board certification, European Society for Medical Oncology.
- 1995 Board certification, German Board of Internal Medicine.
- 1997 Board certification, German Board of Internal Medicine (Hematology and Oncology).
- 2000 Board certification, Quality Management in Medicine.
Memberships in Professional Societies
- Since 1991 German Cancer Society (DKG).
- Since 1991 Wilsede School of Oncology.
- 1991 European Society of Medical Oncology (ESMO).
- 1995 American Society of Clinical Oncology (ASCO).
- 1995 German Society of Hematology/Oncology (DGHO).
- 1998 German Association for Bone Marrow Transplantation (DAGKBT).
Honors and Awards
- Fellowship of the German Academic Scholarship Fund.
- Award of the Ministry of Science for Outstanding Student Achievements in Medicine.
- 2000 National Award of the German Cancer Society.
- 2000 Award for Experimental Urological Research, German Society of Urology.
- 2001 Award of the Cancer Society of Baden Wuerttemberg.
- 2001 Award of the German Society for Clinical Pharmacology.
- 2002 Scientific Award for Medical Oncology.
- 2006 Award of the University of Heidelberg (Anita and Cuno Wieland Award).
- 1997 - 2004 Member of the Research Advisory Committee of the University of Tuebingen.
- 2000 - 2004 Founding Member of the Comprehensive Cancer Center at the University of Tuebingen.
- 2001 - 2004 Founding Member of the Interdisciplinary Center for Soft Tissue Sarcomas at the University of Tuebingen.
- Since 2002 Chairman of the ESMO Examination Committee for Medical Oncology.
- Since 2002 Board Member of the German Society of Hematology and Oncology.
- Since 2005 Board Member of the German Cancer Society.
- Since 2005 Board Member of the Cancer Society of Hamburg.
Photo of the doctor: (c) Universitätsklinikum Hamburg-Eppendorf (UKE)
Accommodation in hospital
- Program [Description]
Treatment of acute myeloid leukemia (AML) with CAR T-cell therapy
- Hospital: University Hospital Hamburg-Eppendorf
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