Combination Chemotherapy With or Without Rituximab in Treating Patients With Relapsed Non-Hodgkin's Lymphoma
- Conditions
- Lymphoma
- Registration Number
- NCT00004179
- Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Monoclonal antibodies such as rituximab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. It is not yet known whether chemotherapy is more effective with or without rituximab for relapsed non-Hodgkin's lymphoma.
PURPOSE: This randomized phase III trial is studying combination chemotherapy and rituximab to see how well they work compared to combination chemotherapy alone in treating patients with relapsed non-Hodgkin's lymphoma.
- Detailed Description
OBJECTIVES:
* Compare the response rate and quality of remission in patients with relapsed follicular non-Hodgkin's lymphoma treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with or without rituximab.
* Compare the event-free survival and overall survival of patients treated with these regimens.
* Determine the effect of rituximab as maintenance therapy on progression-free survival of these patients.
OUTLINE: This is a randomized, multicenter study.
* Induction: Patients are randomized to one of two treatment arms. Patients are stratified according to participating center, prior treatment with purine analogues, age, number of prior induction treatments and best response obtained (complete vs partial remission vs no change/progressive disease), time since diagnosis (less than 2 years vs more than 2 years), and bulky disease (less than 10 cm vs greater than 10 cm).
* Arm I (closed as of 12/20/04): Patients receive induction chemotherapy comprising cyclophosphamide IV, doxorubicin IV, and vincristine IV on day 1 and oral prednisone on days 1-5 (CHOP chemotherapy). Treatment repeats every 3 weeks for 6 courses in the absence of disease progression or unacceptable toxicity.
* Arm II: Patients receive CHOP chemotherapy as in arm I. Rituximab IV is administered 1 hour after prednisone and before the IV drugs.
* Maintenance: Patients who achieve partial or complete remission are then randomized to one of two treatment arms. Patients are stratified according to rituximab administration during induction (yes vs no), quality of the response (complete vs partial remission vs no change/progressive disease), and participating center.
* Arm I: Patients receive no further therapy.
* Arm II: Beginning 8 weeks after the last CHOP course, patients receive rituximab IV once every 3 months for up to 2 years in the absence of disease progression or unacceptable toxicity.
Patients are followed every 3 months for 2 years and then every 4 months thereafter.
PROJECTED ACCRUAL: A total of 752 patients will be accrued for this study within 6 years.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 475
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Response to treatment
- Secondary Outcome Measures
Name Time Method Overall survival from randomization Progression Free survival from randomization
Trial Locations
- Locations (259)
Amphia Ziekenhuis - locatie Molengracht
🇳🇱Breda, Netherlands
Reinier de Graaf Group - Delft
🇳🇱Delft, Netherlands
Sandton Oncology Centre
🇿🇦Johannesburg, South Africa
Mary Potter Oncology Centre
🇿🇦Brooklyn Square, South Africa
Johannesburg General Hospital
🇿🇦Parktown, South Africa
Lund University Hospital
🇸🇪Lund, Sweden
Singleton Hospital
🇬🇧Swansea, England, United Kingdom
Royal Preston Hospital
🇬🇧Preston, England, United Kingdom
Kettering General Hosptial
🇬🇧Kettering, Northants, United Kingdom
Staffordshire General Hospital
🇬🇧Stafford, United Kingdom
Oldchurch Hospital
🇬🇧Romford, England, United Kingdom
Hillingdon Hospital
🇬🇧Uxbridge, England, United Kingdom
Southampton General Hospital
🇬🇧Southampton, England, United Kingdom
Saint Richards Hospital
🇬🇧Chichester, United Kingdom
Hull Royal Infirmary
🇬🇧Hull, United Kingdom
Cancer Therapy Centre at Liverpool Hospital
🇦🇺Liverpool, New South Wales, Australia
Moncton Hospital
🇨🇦Moncton, New Brunswick, Canada
Sydney Cancer Centre at Royal Prince Alfred Hospital
🇦🇺Sydney, New South Wales, Australia
St. George Hospital and Community Health Service
🇦🇺Sydney, New South Wales, Australia
Cancer Centre of Southeastern Ontario at Kingston General Hospital
🇨🇦Kingston, Ontario, Canada
Trillium Health Centre - Mississauga Site
🇨🇦Mississauga, Ontario, Canada
Toronto Sunnybrook Regional Cancer Centre at Sunnybrook and Women's College Health Sciences Centre
🇨🇦Toronto, Ontario, Canada
Saint Bartholomew's Hospital
🇬🇧London, England, United Kingdom
Guy's and St. Thomas' Hospitals NHS Foundation Trust
🇬🇧London, England, United Kingdom
Royal Marsden NHS Foundation Trust - London
🇬🇧London, England, United Kingdom
University College Hospital
🇬🇧London, England, United Kingdom
Concord Repatriation General Hospital
🇦🇺Concord, New South Wales, Australia
Institute of Oncology at Prince of Wales Hospital
🇦🇺Randwick, New South Wales, Australia
Royal North Shore Hospital
🇦🇺St. Leonards, New South Wales, Australia
Westmead Breast Centre at NSW Breast Cancer Institute
🇦🇺Westmead, New South Wales, Australia
Westmead Hospital
🇦🇺Westmead, New South Wales, Australia
Wollongong Hospital
🇦🇺Wollongong, New South Wales, Australia
Townsville General Hospital
🇦🇺Townsville, Queensland, Australia
Ashford Cancer Centre
🇦🇺Ashford, South Australia, Australia
Fremantle Hospital
🇦🇺Fremantle, Western Australia, Australia
Mount Medical Centre
🇦🇺Perth, Western Australia, Australia
Royal Perth Hospital
🇦🇺Perth, Western Australia, Australia
Sir Charles Gairdner Hospital - Perth
🇦🇺Perth, Western Australia, Australia
CancerCare Manitoba
🇨🇦Winnipeg, Manitoba, Canada
St. Joseph's Health Centre - Toronto
🇨🇦Toronto, Ontario, Canada
Rigshospitalet - Copenhagen University Hospital
🇩🇰Copenhagen, Denmark
Vejle Sygehus
🇩🇰Vejle, Denmark
Institut Gustave Roussy
🇫🇷Villejuif, France
Centro di Riferimento Oncologico - Aviano
🇮🇹Aviano, Italy
Jeroen Bosch Ziekenhuis
🇳🇱's-Hertogenbosch, Netherlands
Ijselmeer Ziekenhuis - Zuiderzeeziekenhuis
🇳🇱Almere, Netherlands
Meander Medisch Centrum
🇳🇱Amersfont, Netherlands
Slotervaart Ziekenhuis
🇳🇱Amsterdam, Netherlands
Onze Lieve Vrouwe Gasthuis
🇳🇱Amsterdam, Netherlands
Albert Schweitzerziekenhuis- Zwijndrecht
🇳🇱Amsterdam, Netherlands
University Medical Center Groningen
🇳🇱Groningen, Netherlands
Kennemer Gasthuis - Locatie EG
🇳🇱Haarlem, Netherlands
Rijnland Ziekenhuis
🇳🇱Leiderdorp, Netherlands
Ikazia Ziekenhuis
🇳🇱Rotterdam, Netherlands
Albert Schweitzerziekenhuis- Sliedrecht
🇳🇱Sliedrecht, Netherlands
Holy-Ziekenhuis
🇳🇱Vlaardingen, Netherlands
Reinier de Graaf Group - Voorburg
🇳🇱Voorburg, Netherlands
Hofpoort Ziekenhuis
🇳🇱Woerden, Netherlands
St. Jans Gasthuis Weert
🇳🇱Weert Be, Netherlands
Isala Klinieken - locatie Weezenlanden
🇳🇱Zwolle, Netherlands
Waikato Hospital
🇳🇿Hamilton, New Zealand
Norwegian Radium Hospital
🇳🇴Oslo, Norway
St. Olavs University Hospital
🇳🇴Trondheim, Norway
Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology
🇵🇱Warsaw, Poland
National Cancer Institute - Bratislava
🇸🇰Bratislava, Slovakia
Medical Oncology Centre of Rosebank
🇿🇦Johannesburg, South Africa
University Hospital of Linkoping
🇸🇪Linkoping, Sweden
Sunderby Hospital
🇸🇪Lulea, Sweden
Karolinska University Hospital - Huddinge
🇸🇪Stockholm, Sweden
Sundsvall Hospital
🇸🇪Sundsvall, Sweden
Umea Universitet
🇸🇪Umea, Sweden
Clatterbridge Centre for Oncology NHS Trust
🇬🇧Merseyside, England, United Kingdom
Royal Brisbane and Women's Hospital
🇦🇺Brisbane, Queensland, Australia
Royal Hobart Hospital
🇦🇺Hobart, Tasmania, Australia
Royal Adelaide Hospital Cancer Centre
🇦🇺Adelaide, South Australia, Australia
Tom Baker Cancer Centre - Calgary
🇨🇦Calgary, Alberta, Canada
Institut Jules Bordet
🇧🇪Brussels, Belgium
H. Hartziekenhuis - Roeselaere.
🇧🇪Roeselare, Belgium
Algemeen Ziekenhuis Sint-Augustinus
🇧🇪Wilrijk, Belgium
Wesley Medical Centre
🇦🇺Auchenflower, Queensland, Australia
Princess Alexandra Hospital
🇦🇺Brisbane, Queensland, Australia
Peter MacCallum Cancer Centre
🇦🇺East Melbourne, Victoria, Australia
Frankston Hospital
🇦🇺Frankston, Victoria, Australia
Geelong Hospital
🇦🇺Geelong, Victoria, Australia
St. Vincent's Hospital
🇦🇺Fitzroy, Victoria, Australia
Canberra Hospital
🇦🇺Garran, Australian Capital Territory, Australia
Flinder Medical Centres
🇦🇺Bedford Park, South Australia, Australia
Cross Cancer Institute at University of Alberta
🇨🇦Edmonton, Alberta, Canada
St. John of God Hospital
🇦🇺Ballarat, Victoria, Australia
Austin Hospital
🇦🇺Heidelberg, Victoria, Australia
Queen Elizabeth Hospital
🇬🇧Gateshead, England, United Kingdom
Greenslopes Private Hospital
🇦🇺Greenslopes, Queensland, Australia
Garden Consulting Rooms
🇦🇺Mornington, Victoria, Australia
Box Hill Hospital
🇦🇺Box Hill, Victoria, Australia
U.Z. Gasthuisberg
🇧🇪Leuven, Belgium
Alfred Hospital
🇦🇺Melbourne, Victoria, Australia
Ziekenhuis Netwerk Antwerpen Middelheim
🇧🇪Antwerp, Belgium
Universitair Ziekenhuis Antwerpen
🇧🇪Edegem, Belgium
Algemeen Ziekenhuis Sint Lucas
🇧🇪Ghent, Belgium
John Fawkner Hospital
🇦🇺Coburg, Victoria, Australia
Royal Melbourne Hospital
🇦🇺Parkville, Victoria, Australia
London Regional Cancer Program at London Health Sciences Centre
🇨🇦London, Ontario, Canada
British Columbia Cancer Agency - Centre for the Southern Interior
🇨🇦Kelowna, British Columbia, Canada
Gelre Ziekenhuizen - Lokatie Lukas
🇳🇱Apeldoorn, Netherlands
Streekziekenhuis Gooi-Noord
🇳🇱Blaricum, Netherlands
Ijsselland Ziekenhuis
🇳🇱Capelle aan den Ijssel, Netherlands
Red Cross Hospital
🇳🇱Den Haag, Netherlands
Van Weel Bethesda Ziekenhuis
🇳🇱Dirksland, Netherlands
Northwestern Ontario Regional Cancer Care at Thunder Bay Regional Health Sciences Centre
🇨🇦Thunder Bay, Ontario, Canada
McGill Cancer Centre at McGill University
🇨🇦Montreal, Quebec, Canada
Hopital Du Sacre-Coeur de Montreal
🇨🇦Montreal, Quebec, Canada
Hopital du Saint-Sacrement, Quebec
🇨🇦Quebec City, Quebec, Canada
St. Lucas - Andreas Ziekenhuis
🇳🇱Amsterdam, Netherlands
Vrije Universiteit Medisch Centrum
🇳🇱Amsterdam, Netherlands
Boveny Ziekenhuis
🇳🇱Amsterdam, Netherlands
Deventer Ziekenhuisen
🇳🇱Deventer, Netherlands
Medisch Spectrum Twente
🇳🇱Enschede, Netherlands
Nova Scotia Cancer Centre at Queen Elizabeth II Health Sciences Centre
🇨🇦Halifax, Nova Scotia, Canada
Nanaimo Cancer Clinic at Nanaimo Regional General Hospital
🇨🇦Nanaimo, British Columbia, Canada
Windsor Regional Cancer Centre at Windsor Regional Hospital
🇨🇦Windsor, Ontario, Canada
National Cancer Institute of Egypt
🇪🇬Cairo, Egypt
Maisonneuve-Rosemont Hospital
🇨🇦Montreal, Quebec, Canada
Hopital Notre- Dame du CHUM
🇨🇦Montreal, Quebec, Canada
British Columbia Cancer Agency - Vancouver Cancer Centre
🇨🇦Vancouver, British Columbia, Canada
Allan Blair Cancer Centre at Pasqua Hospital
🇨🇦Regina, Saskatchewan, Canada
Margaret and Charles Juravinski Cancer Centre
🇨🇦Hamilton, Ontario, Canada
Institut Bergonie
🇫🇷Bordeaux, France
Scheperziekenhuis
🇳🇱Amsterdam, Netherlands
Ottawa Hospital Regional Cancer Centre - General Campus
🇨🇦Ottawa, Ontario, Canada
Hotel Dieu Health Sciences Hospital - Niagara
🇨🇦St. Catharines, Ontario, Canada
Newfoundland Cancer Treatment and Research Foundation
🇨🇦St. Johns, Newfoundland and Labrador, Canada
Humber River Regional Hospital - Weston
🇨🇦Weston, Ontario, Canada
Northeastern Ontario Regional Cancer Centre
🇨🇦Sudbury, Ontario, Canada
Hopital Charles Lemoyne
🇨🇦Greenfield Park, Quebec, Canada
Royal Victoria Hospital of Barrie
🇨🇦Barrie, Ontario, Canada
Princess Margaret Hospital
🇨🇦Toronto, Ontario, Canada
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital
🇳🇱Amsterdam, Netherlands
National Institute of Oncology
🇭🇺Budapest, Hungary
Hagaziekenhuis
🇳🇱's-Gravenhage, Netherlands
Medisch Centrum Alkmaar
🇳🇱Alkmaar, Netherlands
Ziekenhuis Lievensberg
🇳🇱Bergen-op-Zoom, Netherlands
Amphia Ziekenhuis - locatie Langendijk
🇳🇱Breda, Netherlands
Atrium Medical Centre - Brunssum
🇳🇱Brunssum, Netherlands
Elkerliek Ziekenhuis
🇳🇱Helmond, Netherlands
Diaconessenhuis Leiden
🇳🇱Leiden, Netherlands
Sint Antonius Ziekenhuis
🇳🇱Nieuwegein, Netherlands
St. Franciscus Gasthuis
🇳🇱Rotterdam, Netherlands
Academisch Medisch Centrum at University of Amsterdam
🇳🇱Amsterdam, Netherlands
Gemini Ziekenhuis
🇳🇱Den Helder, Netherlands
Spaarne Ziekenhuis Haarlem
🇳🇱Haarlem, Netherlands
Ziekenhuis St Jansdal
🇳🇱Harderwijk, Netherlands
Atrium Medical Centre - Heerlen
🇳🇱Heerlen, Netherlands
Academisch Ziekenhuis Maastricht
🇳🇱Maastricht, Netherlands
Nederlandse Hervormde Diaconessenhuisinrichting
🇳🇱Meppel, Netherlands
Nijmegen Cancer Center at Radboud University Medical Center
🇳🇱Nijmegen, Netherlands
Waterlandziekenhuis
🇳🇱Purmerend, Netherlands
University Medical Center Rotterdam at Erasmus Medical Center
🇳🇱Rotterdam, Netherlands
NIJ Smellinghe
🇳🇱Drachten, Netherlands
St. Anna Ziekenhuis
🇳🇱Geldrop, Netherlands
Beatrixziekenhuis
🇳🇱Gorinchem, Netherlands
Diaconessenhuis Eindhoven
🇳🇱Eindhoven, Netherlands
Westfries Gasthuis
🇳🇱Hoorn, Netherlands
Zweedse Rode Kruis Ziekenhuis
🇳🇱La Zierikzee, Netherlands
Groene Hart Ziekenhuis
🇳🇱Gouda, Netherlands
Streekziekenhuis Midden-Twente
🇳🇱Hengelo, Netherlands
Medisch Centrum Leeuwarden - Zuid
🇳🇱Leeuwarden, Netherlands
Ziekenhuis Bernhoven
🇳🇱Oss, Netherlands
Saint Franciscus Ziekenhuis
🇳🇱Roosendaal, Netherlands
Medisch Centrum Rynmond Zuid - Lokatie: Clara
🇳🇱Rotterdam, Netherlands
Ziekenhuis de Honte
🇳🇱Terneuzen, Netherlands
Countess of Chester Hospital
🇬🇧Chester, England, United Kingdom
Martini Ziekenhuis
🇳🇱Groningen, Netherlands
Tjongerschans Ziekenhuis
🇳🇱Heerenveen, Netherlands
Medisch Centrum Haaglanden Antoniushove
🇳🇱Leidschendam, Netherlands
Ziekenhuis Refaja
🇳🇱Stadskanaal, Netherlands
Rivierenland Tiel
🇳🇱Tiel, Netherlands
Twee Steden Ziekenhuis Vestiging Tilburg
🇳🇱Tilburg, Netherlands
'T Lange Land Ziekenhuis
🇳🇱Zoetermeer, Netherlands
Institute of Oncology - Ljubljana
🇸🇮Ljubljana, Slovenia
Doncaster Royal Infirmary
🇬🇧Doncaster, England, United Kingdom
Lorentz Ziekenhuis
🇳🇱Zeist, Netherlands
Leiden University Medical Center
🇳🇱Leiden, Netherlands
Saint Laurentius Ziekenhuis
🇳🇱Roermond, Netherlands
Medisch Centrum Rynmond-Zuid - Lokatie Zuider
🇳🇱Rotterdam, Netherlands
St. Elisabeth Ziekenhuis
🇳🇱Tilburg, Netherlands
St. George's Hospital
🇬🇧London, England, United Kingdom
James Cook University Hospital
🇬🇧Middlesbrough, England, United Kingdom
Bradford Hospitals NHS Trust
🇬🇧Bradford, England, United Kingdom
Conquest Hospital
🇬🇧Canterbury, England, United Kingdom
Scunthorpe General Hospital
🇬🇧Scunthorpe, England, United Kingdom
Taunton and Somerset Hospital
🇬🇧Taunton Somerset, England, United Kingdom
Sandwell General Hospital
🇬🇧West Bromwich, England, United Kingdom
Royal Hampshire County Hospital
🇬🇧Winchester, England, United Kingdom
Royal Infirmary - Castle
🇬🇧Glasgow, Scotland, United Kingdom
Havenziekenhiuis
🇳🇱Rotterdam, Netherlands
Maasland Hospital
🇳🇱Sittard, Netherlands
Mesos Medisch Centrum - Overvecht
🇳🇱Utrecht, Netherlands
Haukeland Hospital - University of Bergen
🇳🇴Bergen, Norway
Newcastle Upon Tyne Hospitals NHS Trust
🇬🇧Newcastle-Upon-Tyne, England, United Kingdom
St. Georges Hospital Medical School
🇬🇧London, England, United Kingdom
Kent and Canterbury Hospital
🇬🇧Canterbury, England, United Kingdom
St Helier Hospital
🇬🇧Carshalton, England, United Kingdom
Oxford Radcliffe Hospital
🇬🇧Oxford, England, United Kingdom
Berkshire Cancer Centre at Royal Berkshire Hospital
🇬🇧Reading, England, United Kingdom
North Staffs Royal Infirmary
🇬🇧Stoke-On-Trent, England, United Kingdom
Ruwaard Van Putten Ziekenhuis
🇳🇱Spykenisse, Netherlands
Oudenrijn Ziekenhuis
🇳🇱Utrecht, Netherlands
St. Joseph Veghel
🇳🇱Veghel, Netherlands
Stoke Mandeville Hospital
🇬🇧Aylesbury-Buckinghamshire, England, United Kingdom
Zaans Medisch Centrum
🇳🇱Zaandam, Netherlands
Isala Klinieken - locatie Sophia
🇳🇱Zwolle, Netherlands
University of Auckland School of Medicine
🇳🇿Auckland, New Zealand
Christchurch Hospital
🇳🇿Christchurch, New Zealand
Birmingham Heartlands Hospital
🇬🇧Birmingham, England, United Kingdom
Maxima Medisch Centrum - locatie Eindhoven
🇳🇱Veldhoven, Netherlands
Instituto Portugues de Oncologia de Francisco Gentil - Centro Regional de Oncologia de Lisboa, S.A.
🇵🇹Lisbon, Portugal
Mount Vernon Cancer Centre at Mount Vernon Hospital
🇬🇧Northwood, England, United Kingdom
Leicester Royal Infirmary
🇬🇧Leicester, England, United Kingdom
Royal Bournemouth Hospital
🇬🇧Bournemouth, England, United Kingdom
Bristol Haematology and Oncology Centre
🇬🇧Bristol, England, United Kingdom
Aintree University Hospital
🇬🇧Liverpool, England, United Kingdom
Cancer Research Centre at Weston Park Hospital
🇬🇧Sheffield, England, United Kingdom
Royal Gwent Hospital
🇬🇧Newport Gwent, Wales, United Kingdom
King George Hospital
🇬🇧Ilford, Essex, England, United Kingdom
Portsmouth Hospitals NHS Trust
🇬🇧Portsmouth, England, United Kingdom
Royal Marsden NHS Foundation Trust - Surrey
🇬🇧Sutton, England, United Kingdom
Torbay Hospital
🇬🇧Torquay Devon, England, United Kingdom
Norfolk and Norwich University Hospital
🇬🇧Norwich, England, United Kingdom
Whiston Hospital
🇬🇧Prescot Merseyside, England, United Kingdom
Salisbury District Hospital
🇬🇧Salisbury, England, United Kingdom
Belfast City Hospital Trust
🇬🇧Belfast, Northern Ireland, United Kingdom
University Hospital of Wales
🇬🇧Cardiff, Wales, United Kingdom
Velindre Cancer Center at Velinde Hospital
🇬🇧Cardiff, Wales, United Kingdom
Southern General Hospital
🇬🇧Glasgow, Scotland, United Kingdom
Glan Clywd District General Hospital
🇬🇧Rhyl, Denbighshire, Wales, United Kingdom
Sahlgrenska University Hospital at Gothenburg University
🇸🇪Gothenburg (Goteborg), Sweden
Orebro University Hospital
🇸🇪Orebro, Sweden
Great Western Hospital
🇬🇧Swindon,, United Kingdom
Prince of Wales Private Hospital
🇦🇺Randwick, New South Wales, Australia
Lions Gate Hospital
🇨🇦North Vancouver, British Columbia, Canada
Fraser Valley Cancer Centre at British Columbia Cancer Agency
🇨🇦Surrey, British Columbia, Canada
Royal United Hospital
🇬🇧Bath, England, United Kingdom
City Hospital - Birmingham
🇬🇧Birmingham, England, United Kingdom
Blackpool Victoria Hospital
🇬🇧Blackpool, England, United Kingdom
Addenbrooke's Hospital at Cambridge University Hospitals NHS Foundation Trust
🇬🇧Cambridge, England, United Kingdom
Cheltenham General Hospital
🇬🇧Cheltenham, England, United Kingdom
Essex County Hospital
🇬🇧Colchester, England, United Kingdom
Russells Hall Hospital
🇬🇧Dudley, England, United Kingdom
Royal Devon and Exeter Hospital
🇬🇧Exeter, England, United Kingdom
Diana Princess of Wales Hospital
🇬🇧Grimsby, England, United Kingdom
Royal Free and University College Medical School
🇬🇧Hampstead, London, England, United Kingdom
Hinchingbrooke Hospital
🇬🇧Huntingdon, England, United Kingdom
Leeds General Infirmary at Leeds Teaching Hospital NHS Trust
🇬🇧Leeds, England, United Kingdom
Pembury Hospital
🇬🇧Royal Tunbridge Wells, Kent, England, United Kingdom
New Cross Hospital
🇬🇧Wolverhampton, England, United Kingdom
Western General Hospital
🇬🇧Edinburgh, Scotland, United Kingdom
Western Infirmary
🇬🇧Glasgow, Scotland, United Kingdom
University Medical Center Utrecht
🇳🇱Utrecht, Netherlands
Royal Liverpool University Hospital
🇬🇧Liverpool, England, United Kingdom