Head of the Center for Research on Malignant Neoplasms of the Blood at the University of Tel Aviv. His breakthrough research in molecular biology and genomics led to the discovery of a new form of childhood leukemia. In the United States, the results of his research are used for clinical trials of drugs against this form of blood cancer in children and adults, and they are also used in routine research all over the world.
Author of over 80 publications.
Senior physician at the Department of Bone Marrow Transplantation and Cancer Immunotherapy.
He was one of the first in Israel who began to carry out bone marrow transplantation operations, he developed innovative stem cell treatment methods.
Professor Omai is a member of reputable associations:
The professor specializes in the diagnosis and treatment of acute leukemia, lymphoma, bleeding disorders, and other hematological diseases.
He is the author of over 150 articles.
Professor Baytan is an experienced bone marrow transplant surgeon. He specializes in the diagnosis and treatment of oncological diseases in children, bleeding, anemia, vascular diseases, and much more.
Professor Baytan has published over 30 articles in international and Turkish peer-reviewed journals. He is the author and co-author of 3 books.
Review from Anna Furina, a patient of the Department of Hematology and Bone Marrow Transplantation at the Tel Aviv Sourasky Medical Center (Ichilov), who came to Israel for treatment with a diagnosis of acute leukemia.
“I’m a mother of 3-year-old Lesha, who received treatment at your center. I want to express my deep admiration for the medical staff. Schneider Hospital (Israel) deserves only positive reviews. The doctors accompanied us all the time and supported us throughout this long time, before and after the operation. I am returning home with my healthy child. Thank you!”
David began the fight against lymphoblastic leukemia at the age of 5, having undergone a course of chemotherapy with positive results that lasted for 6 years. When the boy turned 13, he had a relapse and underwent a bone marrow transplantation, thanks to which hope for a cure emerged. However, David had another relapse, and now all possibilities were exhausted. The treatment option that Dr. Susana Reeves suggested to David and his family was a clinical trial of immunotherapy known as CAR-T 19.
Hospital Sant Joan de Déu.
Treatment by: Doctor Sigal Tavor
Good afternoon! I would like to share my impressions and thoughts on the treatment of leukemia in the Israel Ichilov Hospital. My father, who is himself a former oncologist (now he is engaged in the pharmaceutical business), recommended your hospital, to be more precise, took me by the hand to you. Dad is well up in this area both in Russia and abroad. Therefore, when my diagnosis was confirmed, we decided not to delay and immediately submitted an application through your website and arranged a consultation with Doctor Sigal Tavor.
Frankly speaking, I initially wanted to go to Germany but my father insisted on Israel. He says that oncology is treated the best in your hospital among all other hospitals in the world. Father was not mistaken.
In addition, everything is organized at the highest level. We were met at the airport and accommodated in a hotel near the hospital. They accompanied us to all the necessary diagnostic procedures. I think without them we would just get lost. As I said earlier, we wanted to get exactly to Sigal Tavor and they did not disappoint us. I liked that the reception time, as I understood, is unlimited – until they thoroughly figured out everything and explained all the moments to us, they did not let us go. The doctor made a very positive impression. He is a real specialist!
Leukemia is an oncology disease, which affects the hematopoietic system and in which the bone marrow and other hematopoietic tissues produce an abnormal number of immature or abnormal white blood cells. A malignant clone of cells proliferates and gradually suppresses the formation of normal erythrocytes and platelets, which leads to the development of anemia, impaired blood clotting processes, and a decrease in the body defenses.
There are two forms of leukemia: acute (AL) and chronic (CL). AL accounts for up to 35% of all malignant oncological diseases in children under 15 years of age. In 75% of cases, AL is diagnosed in adults and only 25% in children. Acute myeloid leukemia is revealed in 80% of cases in patients over 40 years of age, while lymphoblastic AL is more common in childhood.
The various symptoms of leukemia are combined into several main clinical syndromes:
The characteristic signs of chronic leukemia may not be observed for several years after the onset of the disease. You can identify the problem by changes in the general blood test.
The most informative are the following laboratory tests:
A variety of cytochemical, cytogenetic, molecular biological methods are also used for diagnosis, which make it possible to confirm the diagnosis of AL or CL, to determine the variant of the course of the disease.
Acute leukemia is potentially curable. The prognosis is better, the younger the patient is. The frequency of remission in children as a result of adequate therapy is 85-95%, and 30-40% of them survive the 5-year line without relapses. A child who underwent treatment for lymphoblastic AL after 5 years of observation in a state of remission is crossed off the register as recovered. The rate of remission in adults is 75-80%.
Chronic leukemia can be kept under control for several years thanks to dynamic observation and repeated courses of treatment.
Statistics are given for countries with a high level of healthcare development: Turkey, Israel, Germany, and Finland. In Russia, such indicators are achievable only for the largest oncohematological centers in the capital. In the regions, as a rule, the prognosis for the sick persons is not the most favorable.
In oncohematology, to treat leukemia, cytostatics are used. These are drugs that disrupt the formation of tumor blood cells. The choice of an effective cytostatic agent or their combination within the framework of polychemotherapy is high art since each of the types of pathological leukocytes needs its own specific drug. Prescribing a cytostatic at random without a full examination is unacceptable since this increases the likelihood of complications and side effects without a chance of saving the patient’s life.
The duration of AL treatment is on average about two years. The treatment plan includes a number of stages such as preparatory treatment, induction (intensive chemotherapy), and long-term maintenance treatment. Depending on the severity of leukemia, chemotherapy can be performed either independently or with a subsequent bone marrow transplantation.
The effectiveness of the treatment depends on a properly selected protocol, on the quality of the drugs administered, and on concomitant treatment to restore blood counts and the whole body after chemotherapy. While taking cytostatics, immunity is often reduced, so prevention of fungal bacterial and viral infections is important. To avoid the complications of chemotherapy, patients in Turkey are often hospitalized for the entire duration of their treatment.
Specialists identify groups of patients with a high risk of relapse, for whom intensive high-dose chemotherapy regimens are insufficient. This category of patients requires allogeneic bone marrow transplantation from a healthy donor who matches the patient in a number of genetic parameters.
The probability of selecting a donor among relatives is small and is only 25%. In this regard, most often the bone marrow for transplantation has to be taken from a person who is not a blood relative of the patient. The basis for the selection of a “donor-recipient” pair is their coincidence in the group of histocompatibility antigens. In such cases, donor bone marrow is taken from an international donor bank.
The procedure for obtaining bone marrow for a donor is relatively safe, easily tolerated and does not lead to disability. It is carried out in a hospital. Under general anesthesia, hematopoietic tissue is removed from the pelvic bones using special needles. On the day of the procedure, the donor can go home.
Bone marrow transplant for a patient with leukemia:
The procedure course: The patient’s own bone marrow is destroyed with the high dosage chemotherapy, as the own bone marrow produces defective cells and maintains the course of the disease.
The actual bone marrow transplant. It is a bit like a regular blood transfusion. The material obtained from the donor is collected in a plastic bag and administered to the patient intravenously.
Post-transplant treatment. Leukocytes, which are produced by the donor’s hematopoietic tissue, recognize the cells of the recipient’s body as foreign and actively attack them. A potentially life-threatening graft versus host reaction develops. To suppress it, immunosuppressants are prescribed, and to reduce the negative consequences of suppressing the activity of the immune system, the patient has to constantly take antibiotics, antiviral and antifungal drugs.
According to statistics from the CIS countries (Ukraine and Russia), the overall mortality rate in bone marrow transplantation reaches 50%. This is clearly an unsatisfactory indicator, since in fact every second patient dies in the course of treatment. For comparison, the same indicator in oncohematological centers in Israel and Turkey is almost three times lower. This gives chances to 2 times more patients to survive and recover.
Three main factors negatively influence the quality of leukemia treatment in CIS countries:
For example, when treating leukemia abroad, it is impossible to imagine a situation that the patient will be deprived of the necessary drugs under the guise of “reducing health care costs” or “supporting a domestic manufacturer.”
Instead of introducing the latest advances in medical hematology oncology, as it is done in the treatment of leukemia abroad, domestic doctors are forced to use combinations of drugs with unknown activity in relation to this disease and various side effects instead of the use of an effective drug. This approach carries the risk of immediate and very severe toxicity and relapse. Moreover, the relapse, in turn, is often fatal for patients with AL. For comparison, modern protocols provide more than 80% of patients with remission, while outdated ones do not exceed 30%.
The situation with transplantation is no better. On the territory of the Russian Federation, there are 6 international and regional registries of bone marrow donors. However, according to the Save Life Foundation, the number of donors registered is negligible. In this regard, bone marrow transplantations from donors from Russian registries are extremely rare. The ban on transplantation of hematopoietic tissue from unrelated donors in Ukraine also does not contribute to the receipt of the necessary medical care by patients with AL and CL. For comparison, patients who are undergoing leukemia treatment in Israel and need hematopoietic tissue transplantation have a choice among several million donors from international registries in Europe and the United States.
Applying for a donor bank for the treatment of acute myeloid and lymphoblastic leukemia abroad costs 10-15 thousand dollars for the patient. A number of states help their citizens pay for these costs.
Experts Medical cooperates with charitable foundations that cover 10-20 thousand euros of the cost of treatment.
Israeli hospitals rely on the active implementation of the latest technologies and a high level of training. An active exchange of information between doctors, the use of drugs, and treatment approaches with proven efficacy allow Israeli doctors to achieve a consistently high result of reaching remission in patients of all ages.
Thus, the effectiveness of the treatment of acute lymphoblastic leukemia in Israel in children is 95% and higher. At the stage of preliminary consultations, hematologists, based on the available examination results, can draw up a treatment plan and give a prognosis regarding survival and remission.
First of all, Experts Medical recommends for the treatment of leukemia hospitals and doctors listed in the TOP 3 of Israel and Turkey. The cost of leukemia treatment in Israel is on average one and a half times higher than in Turkish hospitals.