Hematological outpatient department
The aim of care in the hematological and oncological outpatient department is to ensure outpatient care for the patient in close contact with the primary care physicians. Our hematological-oncological special consultation hours care for patients with all diseases of the hematopoietic system and other cancers as well as immunological diseases. Patients can present themselves here for initial examinations as well as for controls in the further course of the disease. Of course there is a special consultation for bone marrow and stem cell transplant patients.
For the outpatient care patients it is very important that inpatient and outpatient treatments overlap seamlessly and that contact with the primary care physicians is guaranteed. Within the clinic, the close cooperation between the doctors working in the outpatient and inpatient area guarantees that the necessary information is passed on to each patient quickly and completely.
Further information and contact options can be found on the website of the Clinic for Hematology, Oncology & Immunology.
Interdisciplinary outpatient chemotherapy
In the interdisciplinary outpatient chemotherapy (IAC) it is possible to carry out chemotherapy, antibody therapies and blood transfusions on an outpatient basis.
This has the great advantage for the patients that they can leave the clinic on the same day and stay in their home environment. In addition to the hematology / oncology outpatient clinic, several specialist disciplines (dermatology, gastroenterology, urology, radiation therapy, ...) carry out their outpatient therapies in the rooms of the IAC. The advantage of merging outpatient therapies from different specialist disciplines is primarily the uniform organization while maintaining a high standard to ensure therapy planning, implementation and further monitoring. The patient care during the application of the therapy is carried out by an interdisciplinary care team with additional qualifications in oncological care, pain and wound management. In addition to the nursing team, at least two internal oncologists, two urologists, two gastroenterologists, a radiation therapist and a dermatologist work in the IAC. In the registration area and the haematological outpatient department, three qualified medical assistants are responsible for taking up and handling the formalities.
Office hours: Monday to Thursday, 8:00 a.m. to 4:30 p.m., Friday 8:00 a.m. to 2:45 p.m.
Contact: Telephone: 06421/5862784
Procedure in interdisciplinary outpatient chemotherapy
- First presentation: First, there is an information and education talk about the planned treatment, its opportunities and risks. Depending on the discipline, this conversation can also be held during the inpatient stay. Relatives are welcome to take part in the conversation.
- Treatment day: Please register with the control center before starting the treatment. Depending on the illness, we need a referral from your family doctor at different intervals. Before starting therapy, a conversation and a blood sample take place. As soon as the laboratory values are available, therapy can begin. The duration of the treatment varies. Please inquire about this with the nursing staff. After the therapy has ended, a new appointment will be arranged with you.
Supporting offers in the IAC
- Psycho-oncological support: It is possible to take advantage of the office hours of Ms. Elisabeth Wolf, a qualified psychologist. Open consultation hours: Monday and Thursday from 8:00 a.m. to 12:00 p.m. Further therapy by telephone arrangement. Phone: 06421/5863165
- Cosmetic seminar The association "Help with leukemia and cancer Marburg e.V." in cooperation with DKMS Live enables five cosmetic seminars per year. Appointments can be requested from the nursing staff.
Nutritional advice: Nutritional advice can currently be arranged through the IAC's nutritional advice service. Registration through the attending physician.
Inpatient chemotherapy / system therapy
Inpatient therapies usually only take place if outpatient therapy is not possible for clinical reasons or if the type of therapy makes inpatient administration absolutely necessary. Inpatient treatment is sometimes necessary even if there are side effects.
For this you will find an experienced team of senior physicians, specialists, assistant physicians and oncological nurses on our hematological / oncological wards 331a and 331b. On our wards 331a and 331b, in addition to trained nurses, three specialist nurses for oncology, a palliative nurse, three nurses with additional training in wound management and two pain nurses work in the care area. On the medical side, you will be looked after by at least two doctors from hematology / oncology on each ward.
Special hematological diagnostics
We offer a wide range of different methods for lymphoma and leukemia diagnostics (for more information, as well as contact and request options, see the links listed):
- Leukemia diagnostics
- Chimerism analysis after allogeneic bone marrow / blood stem cell transplantation (CD34 chimerism)
- Diagnosis of myeloproliferative syndromes (MPS)
- BRAF (V600E) mutation
- KRAS 12/13 mutation
Flow cytometric cell diagnostics
- Immunological typing of leukemia and lymphoma
- Lymphocyte subpopulation analysis (immune status)
- Stem cell monitoring (CD34 quantification)
- Paroxysmal nocturnal hemoglobinuria (PNH) diagnosis
- Lymphocyte typing from bronchoalveolar lavage
- Aberrant mast cells (especially in mastocytosis)
- MDS diagnostics
- Diagnostics of minimal residual disease in acute leukemia
- Immunophenotyping of myeloma cells
HLA laboratory and molecular hemoserology
- Hemoglobin electrophoresis
- Coombs test directly
- Cold agglutinins
- Cryoglobulins
- Tissue typing for bone marrow / organ donation
- Detection of cytotoxic antibodies
- Crossmatch
Cytological and morphological laboratory
- Differential blood count and bone marrow cytology
- Platelets according to Fonio
Stem cell laboratory
Stem cells for the treatment of diseases are obtained from affected patients (autologous) as well as from voluntary family or third-party donors (allogeneic). After the cells have been collected, all further manufacturing steps necessary for the functionality and safety of the cell products take place in our stem cell laboratory. These include the further processing and preservation of the cells in cryogenic liquid nitrogen, as well as extensive quality controls. In cooperation with the Clinic for Transfusion Medicine and the colleagues in the wards, we mainly manufacture stem cell products from venous blood and bone marrow. These are used to treat life-threatening diseases such as Leukemia or Lymphatic Cancer Needed. We also produce products such as donor lymphocytes (DLI) or mesenchymal stem cells and are involved in cooperations in the manufacture of modern cell therapeutics such as CAR-T cells. The work in the stem cell laboratory is carried out under clean room conditions and in accordance with the strict requirements of “good manufacturing practice” (GMP). The necessary precision in the manufacture of cell products is guaranteed by experienced employees and a quality management system that is constantly being developed and monitored by the responsible regional council and the Paul Ehrlich Institute. An additional voluntary certification by the organization JACIE (Joint Accreditation Committee ISCT-Europe) and the European Society for Blood and Bone Marrow Transplantation (EBMT) also guarantees the greatest possible safety in accordance with current international standards.
More information can be found here.
Bone marrow transplants in Marburg
Bone marrow transplants, or "BMT" for short, have been used successfully for many years, especially in the treatment of malignant diseases of the hematopoietic system (e.g. "leukemia") and the lymphatic system (e.g. "malignant lymphoma"). In Marburg, around 20 allogeneic BMT and around 30 autologous BMT are currently performed each year. Furthermore, new methods are being investigated in Marburg in order to make KMT more effective and more tolerable in the future.
The peculiarity of the Marburg Leukemia Center compared to other centers funded by the José Carreras Leukemia Foundation: It pursues a translational approach, so it serves not only either for pure research or to improve care, but also for direct implementation (translation ) of the research results in patient care at the same location. For this purpose, two hospital rooms in the ward, each with two beds, are declared as "Clinical Trial Units", as a research center in which new drugs are being used in clinical studies in phase I (testing for side effects) and phase II (examination of the effectiveness). Test subjects are blood cancer patients who have been exhausted from therapy and expressly make themselves available for these clinical studies and protocols.
Immuntherapie mit CAR-T Zellen
Bei der CAR-T Zell-Therapie handelt es sich um eine revolutionäre neue Therapieform, die für einige Patienten mit schwer zu behandelnden Erkankungen eine neue kurative Option darstellt. Die Anwendung in Deutschland erfolgt nur in zertifizierten Zentren.
Den Patienten werden in einem speziellen Verfahren, das wir in unseren Klinik in Zusammenarbeit mit der Blutbank durchühren, T-Lymphozyten entnommen. Diese werden dann in einem weiteren Speziallabor so verändert, dass sie die Krebszellen erkennen können. Die Rückgabe erfolgt als Infusion. Die Bindung einer CAR-T Zelle an eine Tumorzelle löst eine starke Immunreaktion aus, die zu einem Untergang der Zelle führt. Die CAR-T Zellen können lange im Körper des Patienten überleben und so erneutes Wachstum verhindern.
In Marburg können wir seit August 2018 für Erwachsene mit rezidiviertem oder refraktärem diffus großzelligem B-Zell-Lymphom (DLBCL) bzw. primär mediastinalem großzelligem B-Zell-Lymphom nach zwei oder mehr systemischen Therapielinien, eine solche Therapie anbieten.Im Jahr 2021 konnten wir unser Angebot um eine Therapie für das rezidivierte/refraktäre Mantelzell-Lymphom erweitern und erwarten noch in diesem Jahr die ersten Patienten mit einem vorbehandeltem Multiplen Myelom behandeln zu können.
Ob eine CAR-T Zell-Therapie sinnvoll und möglich ist, wird für jeden Einzelfall mit einem Expertenteam entschieden.