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
Service
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About the department
The Department of Hematology, Oncology, Adult and Pediatric Rheumatology at the University Hospital Heidelberg 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 bone marrow transplantation and occupy leading positions in this field at the international level. The department is headed by Prof. Dr. med. Carsten Müller-Tidow.
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.
The service range of the department includes:
- Hematology
- Bone marrow transplantation
- Diagnostics and treatment of leukemias
- Acute lymphocytic leukemia
- Chronic lymphocytic leukemia
- Hairy cell leukemia
- T-prolymphocytic leukemia
- Diagnostics and treatment of myelodysplastic syndrome
- Diagnostics and treatment of malignant lymphomas
- Diagnostics and treatment of myeloproliferative diseases
- Chronic myeloid leukemia (BCR-ABL1 mutation)
- Chronic neutrophilic leukemia
- True polycythemia
- Primary myelofibrosis (prefibrotic stage, open primary myelofibrosis)
- Essential thrombocythemia
- Chronic eosinophilic leukemia
- Unclassifiable myeloproliferative neoplasia
- Diagnostics and treatment of multiple myeloma
- Conventional chemotherapy
- High-dose chemotherapy
- Therapy with the use of new drugs (thalidomide, lenalidomide, bortezomib)
- Radiation therapy
- Treatment of complications, as well as maintenance therapy
- Introduction of new therapeutic approaches according to the results of clinical trials
- Kyphoplasty
- Diagnostics and treatment of amyloidosis
- Classical chemotherapy for the firstly diagnosed disease and relapse
- High-dose chemotherapy
- Diagnostics of previously unclassified amyloidosis
- Second opinion during and after chemotherapy
- Oncology
- Diagnostics and treatment of cancer of unknown primary
- Diagnostics and treatment of malignant germ cell tumors (testicular tumors)
- Diagnostics and treatment of malignant bone tumors (osteosarcoma, Ewing's sarcoma)
- Diagnostics and treatment of malignant soft tissue tumors (soft tissue sarcoma)
- Rheumatology
- Diagnostics and treatment of rheumatoid arthritis
- Diagnostics and treatment of spondyloarthritis
- Diagnostics and treatment of vasculitides
- Diagnostics and treatment of collagenoses
- Diagnostics and treatment of autoimmune diseases
- Diagnostics and treatment of sarcoidosis
- Diagnostics and treatment of neuromuscular diseases
- Diagnostics and treatment of inflammatory eye diseases (uveitis)
- Diagnostics and treatment of rheumatological diseases in children and adolescents
- Diagnostics and treatment of fibromyalgia (primary and secondary form)
- Diagnostics and treatment of degenerative changes, crystalline arthropathy
- Diagnostics and treatment of congenital collagenoses and lysosomal storage diseases
- Diagnostics and treatment of other hematologic, oncologic and rheumatic diseases
Curriculum vitae
Prof. Dr. med. Carsten Müller-Tidow studied medicine in Aachen, Bonn and the USA. He began his clinical work in Internal Medicine at the University Hospital Muenster and for several years participated in the scholarship program of the German Research Foundation (DFG) in Los Angeles at the University of California (UCLA). After training to become a Medical Specialist in Internal Medicine at the University Hospital Muenster, he became a Fellow of the Heisenberg Foundation of the German Research Foundation.
In 2009, the doctor received the title of a University Professor of Internal Medicine with a focus on Hematology and Oncology, University of Muenster.
From 2014 to 2017, he served as the Head of the Department of Hematology and Oncology and the Head of the Center for Cellular and Gene Therapy at the University Hospital Halle.
Since February 2017, the doctor is the Head of the Department of Hematology, Oncology, Adult and Pediatric Rheumatology at the University Hospital Heidelberg. He is also a Mof the extended presidium of the National Cancer Center (NCT).
The main clinical focuses of Prof. Müller-Tidow cover the treatment of acute leukemia, myelodysplastic syndrome, lymphomas, multiple myeloma. It is important for him not only to adhere to the highest standards in his daily clinical practice, but also to develop new methods of treatment together with the medical team of the department.
The key research focuses are acute myeloid leukemia, epigenetic changes in tumors, stem cell application and genomics. The professor received many awards for his works.
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About hospital
According to Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany!
The hospital is one of the most advanced and reputable medical institutions not only in Germany but throughout Europe. There are more than 43 specialized departments and 13 medical institutes which cover all fields of modern medicine. A distinctive feature of the hospital is the presence of unique therapeutic methods for the treatment of complex and rare clinical cases.
Due to successful clinical practice, the hospital has been holding leading positions in the international medical arena for many years. The basis for this popularity is the combination of the very latest technologies, competent specialists, and active research activities, which allows introducing of revolutionary diagnostic and treatment methods, which save lives.
In addition to the outstanding medical achievements, it is worth noting a particularly friendly and pleasant atmosphere, and respectful attitude towards the patient. Both doctors and nursing staff make every effort to meet all the needs and wishes of the patient, pay due attention to each clinical case, and have personal communication with the patient, which contributes to a positive treatment result.
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Accommodation in hospital
Patients rooms
The patients of the University Hospital Heidelberg live in comfortable single and double rooms designed in bright colors. Each room is equipped with an ensuite bathroom with a shower and toilet. The patient rooms are quite spacious, they have a table with chairs for receiving visitors. Roomy wardrobes are provided for storing personal belongings. It is possible to connect to the Internet. In addition, the hospital offers enhanced-comfort rooms with a safe, refrigerator, and upholstered furniture. Patients have 24-hour access to the services of medical personnel.
Meals and Menus
The patient and his accompanying person have a daily choice of three menus. If you for some reason do not eat all the products, 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:
Religion
The religious services are available upon request.
Accompanying person
During the inpatient program, an accompanying person may stay with you in a room or hotel of your choice.
Hotel
During the outpatient program, you may live in a hotel of your choice. The managers will help you 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.
- Endovascular treatment of liver pathologies with LigaSureTM, Ultracision® and Habib®-Sealer devices
- Correction of chest deformities in children (Nass operation)
- Minimally invasive direct coronary artery bypass grafting
- Replacement of ascending aorta (David procedure)
- Operations using the da Vinci robotic system
These are primary lung tumors and metastases in the lungs, benign and malignant liver pathologies, thyroid pathologies, gastroesophageal reflux disease, heart rhythm disturbances and heart failure, infertility, fibromyalgia, damages and pathologies of large joints, polyneuropathy and other diseases.
- Thoracic surgery
- Cardiac surgery
- Urology
- Orthopedics and traumatology
- Obstetrics and gynecology
The hospital's team consists of more than 13,000 highly qualified employees