Policlinico San Donatoは、非ホジキンリンパ腫に対するCAR T-cell療法を提供するIRCCS認定研究機関です。治療費は通常約24,700ドルで、免疫療法のフルコース1回分と透明性の高い価格設定が含まれています。Gruppo Ospedaliero San Donatoの一員として、年間400万人以上の患者を治療しています。ミラノに位置し、イタリア屈指の医療研究拠点へのアクセスを提供します。
","text_type":"mt_wow_description","best_texts":{"techniques":"CAR T-cell療法","good_fit_for":"非ホジキンリンパ腫","why_its_ranked":"CAR T-cell療法を提供し、患者コーディネーションのための専門国際部門を有しています。腫瘍学の研究で知られるGruppo Ospedaliero San Donatoの一部です。"},"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}],"procedure_prices":[{"prices":{"price_from":350,"price_to":550,"currency":"USD","id":15192},"diagnostic":{"id":296,"name":"CT検査","alias":"ct-scan-of-the-body-part"}},{"prices":{"price_from":503,"price_to":553,"currency":"USD","id":15193},"diagnostic":{"id":6,"name":"MRI検査","alias":"mri-one-department"}}],"reviews":[],"clinic":{"id":298,"alias":"irccs-policlinico-san-donato","name":"San Donato Hospital","logo":"https://s3.eu-central-1.amazonaws.com/bookimed/clinic_logo/298-6ab44dd379f2e.png","short_description":"ポリクリニコ・サン・ドナートは、心臓病学および心臓外科における先進的なイタリアのクリニックです。
\n医師たちは年間9,400件を超える開心術および低侵襲的な心臓・血管手術を施行しており、これは国内最多の件数です。
\n心臓病学、心臓外科、不整脈学、およびリハビリテーションが、サン・ドナート病院における主要な専門診療科です。
","images":[{"base_url":"clinic/5bd86b64641d2","title":"San Donato Hospital main building exterior in Milan, Italy"},{"base_url":"clinic/5bd86b67a042f","title":"Advanced operating room with medical equipment at San Donato Hospital, Italy"},{"base_url":"clinic/5bd86b6517028","title":"Bright hospital corridor at San Donato Hospital, Milan, Italy"},{"base_url":"clinic/5bd86b65d221a","title":"Ceiling skylight and decorative panel at San Donato Hospital, Italy"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":true}],"geo":{"country":{"name":"イタリア","id":127,"alias":"italy","iso_code":"IT"},"city":{"name":"ミラノ","id":353,"alias":"milan"},"address":"Piazza Edmondo Malan, 2, 20097 San Donato Milanese MI, Italy"},"rating":{"rating":4.8,"google":3.2,"percent_of_satisfied_clients":94},"statistics":{"number_of_reviews":55,"doctors_number":350,"year_foundation":1969},"accreditations":[{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5ceb7263b067a.jpeg","name":"科学研究および医療認定のための科学研究所","country_code":"IT"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/609cdeda74941.jpeg","name":"ニューズウィーク「世界のベスト病院 2021」","country_code":"US"}],"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}]}},{"text":"サン・ラッファエーレ病院は、世界で初めてADA-SCIDに対する幹細胞療法を導入し、年間52,000件以上の手術を行っています。腫瘍学の契約教授でありリンパ腫ユニットのディレクターであるAndrés J. M. Ferreri博士は、CAR T細胞治療を専門としています。ビデオコンサルテーションは約410米ドルで、専門的な医療レビューと治療計画の議論が含まれます。同病院は、ISO基準を備えた科学研究・ヘルスケア機関としての認定を受けています。
","text_type":"mt_wow_description","best_texts":{"techniques":"CAR T細胞療法","good_fit_for":"白血病および血液癌","why_its_ranked":"年間140件以上の骨髄移植を実施しており、Fabio Ciceri教授のような専門家がCAR T細胞療法の試験を主導しています。移植の60%が同種移植であり、高度な能力を示しています。"},"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}],"procedure_prices":[{"prices":{"price_from":400000,"price_to":650000,"currency":"USD","id":28268},"operation":{"id":800,"name":"CAR-T細胞療法","alias":"car-t-cell-therapy"}},{"prices":{"price_from":386.7676142929087,"price_to":386.7676142929087,"currency":"USD","id":29079},"diagnostic":{"id":523,"name":"オンライン相談（腫瘍専門医）","alias":"online-consultation-with-oncologist"}},{"prices":{"price_from":385,"price_to":385,"currency":"USD","id":47107},"diagnostic":{"id":104,"name":"血液内科相談","alias":"consultation-hematologist"}}],"reviews":[],"clinic":{"id":303,"alias":"ospedale-san-raffaele","name":"San Raffaele","short_description":"オスペダーレ・サン・ラッファエーレ（サン・ラッファエーレ研究病院）はミラノに位置するヨーロッパ最大規模の研究病院の一つです。希少な免疫系疾患および遺伝性疾患の治療に特化したアドホックな治療法を適用しています。 主な実績として、重症複合免疫不全症（ADA-SCID）患者様に対する世界初の幹細胞療法の実施が挙げられます。 腫瘍内科・腫瘍血液内科・脳神経外科・神経内科・心臓血管外科・泌尿器科・婦人科が当院の最も優れた専門分野です。 当院の外科医は年間52,000件以上の手術を実施しています。
\n","images":[{"base_url":"clinic/656dd8c9f33b6","title":"San Raffaele Clinic modern exterior with glass dome in Milan, Italy"},{"base_url":"clinic/656dd90cb7c2d","title":"San Raffaele Hospital exterior with modern buildings and fountain in Milan, Italy"},{"base_url":"clinic/656dd922de3c2","title":"San Raffaele Hospital exterior with modern medical buildings in Milan, Italy"},{"base_url":"clinic/656dd97bd7773","title":"Waiting area at San Raffaele Clinic Milan with modern chairs and natural light"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":true}],"geo":{"country":{"name":"イタリア","id":127,"alias":"italy","iso_code":"IT"},"city":{"name":"ミラノ","id":353,"alias":"milan"},"address":"Piazza Edmondo Malan, 2, 20097 San Donato Milanese MI, Italy"},"rating":{"rating":4.6,"google":3.2,"percent_of_satisfied_clients":85},"statistics":{"number_of_reviews":71,"doctors_number":350,"year_foundation":1969},"accreditations":[{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5ceb7263b067a.jpeg","name":"科学研究および医療認定のための科学研究所","country_code":"IT"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/609cdeda74941.jpeg","name":"ニューズウィーク「世界のベスト病院 2021」","country_code":"US"}],"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}]}}],"meta":{"total_count":2,"total_pages":1}},"clinicsMeta":{"total_count":2,"total_pages":1},"clinicsCount":2,"clinicsCountByEntity":{"clinic_count":29},"doctors":{"doctors":[{"card_text":"CAR-T細胞療法の臨床試験における主任研究者 – チチェリ教授は、サン・ラファエレ病院の血液学および骨髄移植ユニットを率いています。
ファビオ・チチェリ医師は、サン・ラッファエーレ研究病院の血液学・骨髄移植ユニットを統括しています。細胞・遺伝子治療の臨床試験における主任研究員であり、血液がん、免疫不全、神経筋疾患の治療を行っています。チチェリ医師が勤務するサン・ラッファエーレ病院は、ADA-SCIDに対する世界初の幹細胞治療を成功させた病院です。
オスペダーレ・サン・ラッファエーレ（サン・ラッファエーレ研究病院）はミラノに位置するヨーロッパ最大規模の研究病院の一つです。希少な免疫系疾患および遺伝性疾患の治療に特化したアドホックな治療法を適用しています。 主な実績として、重症複合免疫不全症（ADA-SCID）患者様に対する世界初の幹細胞療法の実施が挙げられます。 腫瘍内科・腫瘍血液内科・脳神経外科・神経内科・心臓血管外科・泌尿器科・婦人科が当院の最も優れた専門分野です。 当院の外科医は年間52,000件以上の手術を実施しています。
\n","images":[{"base_url":"clinic/656dd8c9f33b6","title":"San Raffaele Clinic modern exterior with glass dome in Milan, Italy"},{"base_url":"clinic/656dd90cb7c2d","title":"San Raffaele Hospital exterior with modern buildings and fountain in Milan, Italy"},{"base_url":"clinic/656dd922de3c2","title":"San Raffaele Hospital exterior with modern medical buildings in Milan, Italy"},{"base_url":"clinic/656dd97bd7773","title":"Waiting area at San Raffaele Clinic Milan with modern chairs and natural light"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":true}],"geo":{"country":{"name":"イタリア","id":127,"alias":"italy","iso_code":"IT"},"city":{"name":"ミラノ","id":353,"alias":"milan"},"address":"Piazza Edmondo Malan, 2, 20097 San Donato Milanese MI, Italy"},"rating":{"rating":4.6,"google":3.2,"percent_of_satisfied_clients":85},"statistics":{"number_of_reviews":71,"doctors_number":350,"year_foundation":1969},"accreditations":[{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5ceb7263b067a.jpeg","name":"科学研究および医療認定のための科学研究所","country_code":"IT"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/609cdeda74941.jpeg","name":"ニューズウィーク「世界のベスト病院 2021」","country_code":"US"}]},"procedure_prices":[{"prices":{"price_from":400000,"price_to":650000,"currency":"USD","id":28268},"operation":{"id":800,"name":"CAR-T細胞療法","alias":"car-t-cell-therapy"}}]}],"meta":{"total_count":1,"total_pages":1}},"reviews":{"reviews":[],"meta":{"total_count":6,"total_pages":1}},"offers":{"cards":[],"metadata":{"total_count":0}},"listingTexts":{"entity_texts":{"txt_country":{"text":"CAR T細胞療法でイタリアが選ばれる理由とは？
\n信頼できるクリニックで、先進的なCAR T細胞療法を受けましょう [from-cost]。
"},"txt_price":{"text":"イタリアにおけるCAR-T細胞療法の費用は、臨床経路全体で通常_op_800_price_from_から_op_800_price_to_の範囲です。最終的な価格は、特定の医薬品、必須の入院モニタリング期間、および潜在的な副作用の管理状況によって異なります。米国ではこの治療法の平均費用が_price_compare_US_average_であるのに対し、イタリアでは約_price_percent_discount_%の費用を抑えることが可能です。イタリアのほとんどのプロトコルには、細胞採取、研究所での製造、およびミラノまたはローマでの専門的な入院ケアが含まれています。
\n\nBookimed専門家の見解：ミラノのサン・ラッファエーレ病院のような研究に重点を置いたセンターを選択することで、ファビオ・チチェリ教授のような世界的に著名な血液専門医による治療を受けることができます。ニューズウィーク誌により「世界最高の病院」の一つに選ばれたこのクリニックでは、約140,150ドルからCAR-T細胞療法を提供しています。この基本価格には不可欠な処置が含まれていますが、IRCCS認定施設に滞在することで、複雑な遺伝的および免疫関連の症例を管理するための最高水準の医療が保証されます。
"}},"texts":{}},"faq":[{"id":"69f44dab1bb4d1db69039922","question":"イタリアでCAR-T細胞療法は利用できますか？","answer":"CAR-T細胞療法は、イタリアにおいて、リンパ腫や白血病などの再発性または難治性の血液悪性腫瘍に対する標準治療として利用可能です。イタリア医薬品庁（AIFA）がこれらの治療法を規制しており、主にIRCCS認定の専門研究病院や大学病院を通じて提供されています。
Bookimedの専門家意見： サン・ラファエレのようなイタリア北部のクリニックは最も多くの患者を扱っていますが、ナポリのカルダレッリ病院のようなイタリア南部のセンターの方が、行政手続きをより迅速に進められる傾向があるというデータがあります。北部のセンターは施設数が多いにもかかわらず需要が高いため、患者は各地域の待ち時間を比較検討すべきです。
患者のコンセンサス： 強力な事前の化学療法が適格性に影響を与える可能性があるため、早期の治療相談が不可欠です。患者からは、事前承認プロセスが厳格であり、数ヶ月の待ち時間が必要になる場合があるとの指摘が多く寄せられています。
","is_active":true,"category":{"id":"68f5f2ea1567cb687e0a7542","name":"faq_content","title":"faq_content"}},{"id":"69f44deb1bb4d1db69039923","question":"イタリアでCAR-T細胞療法の対象となるのは誰ですか？","answer":"イタリアでCAR-T細胞療法を受けるには、再発性または難治性の血液腫瘍疾患を患っている必要があります。候補者は、少なくとも2つの以前の全身療法ラインで効果が得られなかったことが条件となります。イタリア医薬品庁（AIFA）は、ミラノのサン・ラッファエーレ病院のような専門センターを通じてアクセスを規制しています。
Bookimedの専門家の意見: イタリアは欧州医薬品庁の基準に従っていますが、イタリア医薬品庁はしばしばより厳しい年齢制限を設けています。サン・ラッファエーレ病院のファビオ・シチェリ教授は、より早いアクセスを提供する可能性のある細胞療法の重要な試験を主導しています。患者は薬剤の製造に3〜6ヶ月待つことが多いため、センターへの早期紹介が不可欠です。
患者のコンセンサス: 多くの患者は承認プロセスを厳格だと感じており、時には「宝くじ」のようだと表現することもあります。製造期間中も健康を維持するためには、治療ライン間の迅速な移行が重要です。
","is_active":true,"category":{"id":"68f5f2ea1567cb687e0a7542","name":"faq_content","title":"faq_content"}},{"id":"69f44e3198ac5374140c8ce2","question":"CAR-T細胞療法はイタリアの医療制度でカバーされていますか？","answer":"イタリアの国民保健サービス（Servizio Sanitario Nazionale）は、基準を満たす患者に対してCAR-T細胞療法を全額カバーしています。イタリア医薬品庁（AIFA）はこれらの治療法に革新的ステータスを付与しており、特定の再発性または難治性のB細胞悪性腫瘍および多発性骨髄腫の治療において、認可された血液学センターで公的資金が適用されることを意味します。
Bookimedの専門家意見： イタリアは完全な公的補償を提供していますが、認定センターがロンバルディア州とラツィオ州に集中しているため、地理的な不均衡が生じています。サン・ラファエレ病院はIRCCSの研究認定と膨大な臨床実績（年間30万人の患者）を兼ね備えているため、患者は同病院を選ぶ傾向があります。これにより、小規模な地域病院よりもAIFAの複雑な薬剤登録要件を迅速にクリアできます。
患者のコンセンサス： 患者は、治療自体は国民にとって無料であるものの、承認プロセスに6ヶ月かかる可能性があると指摘しています。多くの患者は、3ヶ月から12ヶ月の待機期間を効率的に管理するために、AIFA承認センターで適格性の確認を早めに開始することを推奨しています。
","is_active":true,"category":{"id":"68f5f2ea1567cb687e0a7542","name":"faq_content","title":"faq_content"}},{"id":"69f44e6cc4d6f7e9ef060a02","question":"イタリアでCAR-T細胞療法の主要なセンターとなっている病院はどこですか？","answer":"イタリアはCAR-T細胞療法の世界的リーダーであり、ミラノのサン・ラファエレ病院とローマのバンビーノ・ジェズ小児病院が主要なセンターです。AIFA（イタリア医薬品庁）の認可を受けたこれらのセンターは、成人血液学および小児神経芽腫に対する細胞・遺伝子治療の臨床試験を専門としています。
Bookimedの専門家意見： データによると、サン・ラファエレは幹細胞分野における世界的なブレイクスルーとCAR-Tの応用を統合し、独自の地位を築いています。多くのセンターが標準的なプロトコルを提供していますが、IRCCSの認定を受けたミラノの施設は、より多くの患者を受け入れています。この集中的な経験は、複雑な免疫反応に対するより信頼性の高い多職種によるモニタリングにつながることがよくあります。
","is_active":true,"category":{"id":"68f5f2ea1567cb687e0a7542","name":"faq_content","title":"faq_content"}},{"id":"69f44eaac4d6f7e9ef060a03","question":"イタリアにおけるCAR-T細胞療法へのアクセスの主な障壁は何ですか？","answer":"イタリアにおけるCAR-T細胞療法へのアクセスは、センターの地理的な不均等な分布、複雑な地域別の償還プロセス、および厳格な選択基準によって困難になっています。AIFAの承認にもかかわらず、認定クリニックの70%が北部および中部の4つの地域に集中しており、5つの南部地域では地域内でのアクセスが制限されています。
Bookimedの専門家の意見： 標準的なCAR-Tの経路では長い待ち時間が予想されますが、ミラノは国際的な患者や地元の患者にとって戦略的な選択肢であり続けています。サン・ラッファエーレのようなクリニックは、大規模な臨床試験と大規模な血液学部門を組み合わせています。遺伝子治療試験における彼らの役割は、多くの場合、小規模な地域センターよりも早く技術へのアクセスを可能にします。
患者のコンセンサス： 患者からは、公的補償があるにもかかわらず、6〜12か月の待ち時間が発生するため、早期にサポートグループを巻き込む必要があるとの報告があります。償還に関する複雑な不服申し立てプロセスを迅速化するために、治療に関する完全な文書を直ちに確保することを推奨する声が大多数です。
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Fly if no toxicity, counts acceptable."},"follow_up_visits":[{"purpose":"assessment","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"Frequent early monitoring for cytokine release syndrome and neurotoxicity if discharged"}},{"purpose":"result_review","requirement":"routine","after":{"min":28,"max":35,"unit":"days","qualifier":"First response assessment, about day 28-35 after infusion"}},{"purpose":"result_review","requirement":"routine","after":{"min":85,"max":100,"unit":"days","qualifier":"Response reassessment about day 85-100 (around 3 months) after infusion"}}],"indications":["Relapsed or refractory large B-cell lymphoma","Relapsed or refractory B-cell acute lymphoblastic leukemia","Relapsed or refractory follicular and mantle cell lymphoma","Relapsed or refractory multiple myeloma (BCMA-directed)","Relapsed or refractory chronic lymphocytic leukemia"],"main_risks":["Cytokine release syndrome","Immune effector cell-associated neurotoxicity syndrome","Prolonged cytopenias","Infections and hypogammaglobulinemia","B-cell aplasia","Hemophagocytic lymphohistiocytic-like syndrome","Secondary T-cell malignancies (rare)","Tumor lysis syndrome","Infusion-related hypersensitivity reactions"],"pain":"The infusion itself is generally painless; fever, headache, body aches and malaise may occur with cytokine release, and leukapheresis involves line placement with mild discomfort.","preparation":["Specialist eligibility assessment and disease staging","Infection screening and organ function evaluation","Leukapheresis to collect the patient's T cells","Possible bridging therapy while the cells are manufactured (weeks)","Lymphodepleting chemotherapy a few days before infusion","Central venous access as needed","Arrange nearby accommodation and a caregiver after infusion","Confirm target antigen (e.g., CD19, BCMA) and prior-therapy eligibility","Pre-infusion premedication (paracetamol and antihistamine)","Access to tocilizumab and ICU-level support before infusion"],"recovery_timeline":[{"phase":"Infusion and first 1-2 weeks","description":"Single IV infusion followed by close monitoring for cytokine release syndrome and neurotoxicity, usually peaking in the first 1-2 weeks.","restrictions":["Stay near the treatment center"]},{"phase":"Weeks 2-4","description":"Discharge when stable, frequent visits, blood count and infection monitoring, first response assessment around day 28.","restrictions":["Stay near the treatment center until about day 28","No driving for at least 8 weeks","Avoid crowds and infection exposure"]},{"phase":"Months 2-12","description":"Gradual recovery of blood counts and energy, immune function monitoring, immunoglobulin replacement if needed, response reassessment.","restrictions":["Delay live vaccines per specialist advice"]}],"rehabilitation_days":{"min":60,"max":90,"unit":"days","qualifier":"Functional recovery after the 4-week monitoring period; slower with persistent fatigue, cytopenias, neurotoxicity or infections."},"result_longevity":"In large B-cell lymphoma, about 40% remain progression-free at 1 year; some stay in long-term remission. In B-ALL, about 36% relapse; CAR T cells can persist up to about 5 years.","revision_rate_pct":null,"scars":"There is no surgical incision, only small puncture marks from the leukapheresis or central venous line sites.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One CAR T-cell infusion; leukapheresis and lymphodepletion are preceding stages."},"stages":[{"code":"leukapheresis","label":"Leukapheresis to collect T cells","after":{"min":0,"max":0,"unit":"days","qualifier":"Starting point of the treatment pathway"}},{"code":"lymphodepletion","label":"Lymphodepleting chemotherapy","after":{"min":23,"max":58,"unit":"days","qualifier":"About 3-8 weeks after leukapheresis; 2-5 days before infusion"}},{"code":"car_t_infusion","label":"CAR T-cell infusion","after":{"min":28,"max":63,"unit":"days","qualifier":"Depends on manufacturing and product release time"}}],"qualifier":"Single-infusion therapy; timelines vary by product and center."},"success":{"metric":"Complete response rate in relapsed/refractory large B-cell lymphoma (3rd-line or later)","value":51,"unit":"percent","horizon":"Best response, typically assessed at 1-3 months after infusion","evidence_status":"limited","population":"Adults with relapsed/refractory LBCL after two or more prior lines"},"techniques":[{"name":"Autologous CD19-directed CAR T-cell therapy","suits_whom":"Relapsed/refractory B-cell lymphomas and B-ALL","recovery":"Inpatient monitoring about 10-21 days, then nearby follow-up to day 28."},{"name":"Autologous BCMA-directed CAR T-cell therapy","suits_whom":"Relapsed/refractory multiple myeloma after multiple prior lines","recovery":"Similar monitoring; prolonged cytopenias are common."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":0.5,"max":1,"unit":"hours","qualifier":"Duration of the single CAR T-cell infusion itself; leukapheresis (about 3-6 hours) and lymphodepletion are separate."},"initial_assessment_documents":["Pathology report with CD19 or BCMA status","Summary of prior treatment lines and responses","Recent PET-CT or MRI report","Bone marrow biopsy report","Recent CBC, kidney and liver function tests","Echocardiogram report (if available)"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Cell collection, then 3-9 weeks manufacturing, usually at home; return for infusion and 4+ weeks nearby. One trip means staying."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask the clinic for examples of the practitioners' experience with the exact procedure you are planning","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Ask for examples of the practitioners’ experience with the surgery you are intending to have.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Ask whether a doctor is always present in the clinic and whether a high dependency or intensive care unit exists","scope":"treatment_abroad","source":{"url":"https://www.bapras.org.uk/public/patient-information/cosmetic-surgery/cosmetic-surgery-abroad","host":"bapras.org.uk","quote":"Is there always a doctor in the clinic and is there a high dependency or intensive care 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offers.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Confusion or difficulty communicating","urgency":"emergency","general":false,"source":{"url":"https://www.cancer.gov/news-events/cancer-currents-blog/2019/cancer-immunotherapy-investigating-side-effects","host":"cancer.gov","quote":"Patients also may experience neurologic symptoms such as confusion, tremors, or difficulty communicating.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W2","text":"Excessive sleepiness","urgency":"contact_clinic","general":false,"source":{"url":"https://www.cancer.gov/about-cancer/treatment/research/car-t-cells","host":"cancer.gov","quote":"Some of the hallmark signs of ICANS include confusion, excessive sleepiness, and impaired 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