{"translation_price":"50","translation_doc_price":"40","child_coefficient":"1.1","transfer_price":"2.00","transfer_price_vip":"5.00","constant_transfer_price_vip":350,"constant_transfer_price":150,"constant_transfer_distanse":60,"type":"treatment","program_full_story":"<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 lymphoblastic leukemia (ALL) 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 style=\"text-align: justify;\"><strong>Days 1-2<\/strong>. Initial presentation at the clinic. The doctor collects the patient&#39;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 style=\"text-align: justify;\"><strong>Day 3<\/strong>. Collecting patient&rsquo;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 style=\"text-align: justify;\"><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&#39;s own immune system, which will allow CAR T-cells to fight the tumor more effectively.<\/p>\n\n<p style=\"text-align: justify;\"><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 style=\"text-align: justify;\"><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 lymphoblastic leukemia (ALL) 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 style=\"text-align: justify;\"><strong>Days 1-2<\/strong>. Initial presentation at the clinic. The doctor collects the patient&#39;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 style=\"text-align: justify;\"><strong>Day 3<\/strong>. Collecting patient&rsquo;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 style=\"text-align: justify;\"><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&#39;s own immune system, which will allow CAR T-cells to fight the tumor more effectively.<\/p>\n\n<p style=\"text-align: justify;\"><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 style=\"text-align: justify;\"><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>","is_ambulant":"0","bh_fee":"0","only_for_children":"0","no_service":"0","with_prepayment":"1","show_calculator":"1","paket_type":"1","btn_type":"0","clinic_icon":"5ffc406182699.jpg","city":"Mannheim","clinic_site":"https:\/\/w2.umm.de\/start\/","department_recommend":"1","country":"Germany","country_id":"1","clinic_name":"University Hospital Mannheim","cinic_name":"University Hospital Mannheim","department_id":"2410","duration":"21","direction":"Hematology","min_duration":0,"clinic_id":"1733","paketPrice":36000,"paket":"<ul>\n <li>Interpreter up to 80 hours<\/li>\n <li>Translation up to 15 pages<\/li>\n <li>Visa support<\/li>\n<\/ul>","title":"Treatment of acute lymphoblastic leukemia (ALL) with CAR T-cell therapy","price":{"val":495983.27,"type":"val"},"price_surcharge":0,"price_surcharge_clear":0,"extra_service_clinic":[{"id":"need_to_use_head_doctor","title":"Treatment by leading experts","type":"val","val":null,"req":0},{"id":"1_person_room","title":" Single room (whole period)","parent":"duration","type":"count_val","val":"42.00"},{"id":"attendant_place","title":"Accommodation for the accompanying person ","parent":"duration","type":"count_val","val":"90.00"}],"extra_service":[],"translation_hours":"0","translation_doc_count":null,"roads":[{"id":"6","distance":"69","airport_title":"Frankfurt a.M."},{"id":"19","distance":"128","airport_title":"Stuttgart"},{"id":"27","distance":"237","airport_title":"N\u00fcrnberg"}],"pakets":[],"lang":{"day":"Day","days":"days","ambulatory":"Outpatient","stationaryProgram":"Inpatient"}}