A Study Comparing Maintenance Subcutaneous Rituximab With Observation Only in Participants With Relapsed or Refractory Indolent Non-Hodgkin's Lymphoma Who Had Responded to Rituximab-based Immunochemotherapy Induction and 2-year Maintenance With Subcutaneous Rituximab
- Conditions
- Non-Hodgkin's Lymphoma
- Interventions
- Drug: Chemotherapy (Induction Period)Drug: Rituximab
- Registration Number
- NCT01461928
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
This multicenter, randomized, open-label, parallel-group study will evaluate the efficacy and safety of subcutaneously administered rituximab in comparison with observation only as maintenance therapy in participants with relapsed or refractory indolent Non-Hodgkin's lymphoma (NHL). All participants will receive induction therapy with rituximab (375 milligrams per square meter \[mg/m\^2\] intravenously \[IV\] in Cycle 1, then 1400 mg subcutaneous \[SC\] every 3-4 weeks) plus standard chemotherapy for 6-8 months; followed by 24 months of maintenance I period with rituximab (1400 mg SC every 8 weeks). Participants completing therapy and showing partial or complete response will be randomized to receive either rituximab (1400 mg SC every 8 weeks) or observation with no treatment during maintenance II period and will be followed for at least 15 months. Anticipated time on study treatment is until disease progression, unacceptable toxicity or end of study, whichever occurs first.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 692
- Histologically confirmed Cluster of Differentiation 20-positive (CD20+) follicular NHL Grade 1, 2 or 3a, or other CD20+ indolent NHL (Waldenström's macroglobulinemia or lymphoplasmacytic lymphoma, marginal zone lymphoma) according to World Health Organization (WHO) classification system
- Participants must have received and must have relapsed or been refractory to, one or more lines of adequate therapy prior to enrollment, including at least one line consisting of immunotherapy and/or chemotherapy and/or radiotherapy
- Eastern Cooperative Oncology Group (ECOG) performance status less than or equal to (<=) 2
- Transformation to high-grade lymphoma
- Aggressive lymphoma (for example, mantle cell lymphoma [MCL])
- Presence or history of central nervous system (CNS) lymphomatous disease
- Other malignancy within 5 years prior to enrollment, except for curatively treated carcinoma in situ of the cervix, squamous cell carcinoma of the skin or basal cell skin cancer, or cervical carcinoma Stage 1B or less, breast cancer in situ or localized prostate cancer Stage T1c if treated with curative intent and relapse- and metastasis-free for at least 2 years prior to enrollment
- Inadequate hematological, hepatic or renal function
- Known human immunodeficiency virus (HIV) infection
- Active and/or severe infection (e.g. tuberculosis, sepsis and opportunistic infections, active hepatitis B or C)
- Pregnant or breastfeeding women
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Maintenance II Period Observation Only Chemotherapy (Induction Period) Participants will receive standard chemotherapy regimen in combination with 375 mg/m\^2 rituximab IV in Cycle 1 (3-4 week-cycles), followed by 1400 mg rituximab SC every 3-4 weeks for 8 cycles (induction period); 1400 mg rituximab SC every 8 weeks for 24 months (Maintenance I period); no treatment in Maintenance II period until disease progression or end of study, whichever occurs first. Maintenance II Period Rituximab Chemotherapy (Induction Period) Participants will receive standard chemotherapy regimen in combination with 375 mg/m\^2 rituximab IV in Cycle 1 (3-4 week-cycles), followed by 1400 mg rituximab SC every 3-4 weeks for 8 cycles (induction period); 1400 mg rituximab SC every 8 weeks for 24 months (Maintenance I period); 1400 mg rituximab SC every 8 weeks until disease progression or end of study, whichever occurs first (Maintenance II period). Maintenance II Period Observation Only Rituximab Participants will receive standard chemotherapy regimen in combination with 375 mg/m\^2 rituximab IV in Cycle 1 (3-4 week-cycles), followed by 1400 mg rituximab SC every 3-4 weeks for 8 cycles (induction period); 1400 mg rituximab SC every 8 weeks for 24 months (Maintenance I period); no treatment in Maintenance II period until disease progression or end of study, whichever occurs first. Maintenance II Period Rituximab Rituximab Participants will receive standard chemotherapy regimen in combination with 375 mg/m\^2 rituximab IV in Cycle 1 (3-4 week-cycles), followed by 1400 mg rituximab SC every 3-4 weeks for 8 cycles (induction period); 1400 mg rituximab SC every 8 weeks for 24 months (Maintenance I period); 1400 mg rituximab SC every 8 weeks until disease progression or end of study, whichever occurs first (Maintenance II period).
- Primary Outcome Measures
Name Time Method Maintenance II: Progression-free Survival (PFS) Using 1999 International Working Group (Cheson) Response Criteria for Lymphoma or by the Recommendations for Waldenström's Macroglobulinemia From randomization (Maintenance II) up to disease progression or death, whichever occurs first (up to approximately 24 months) Progression free survival from randomization (PFSrand) is defined as the time from date of randomization to the date of first documented disease progression or death, whichever occurs first. One participant died in Induction before randomization and one participant died in Maintenance II Observation arm due to an SAE and were not considered in the analysis as no death page was completed. The Observation arm did not include one participant with AE outcome of death reported retrospectively 2 months after discontinuation from study (censored as having no event on Day 456 post-randomization).
- Secondary Outcome Measures
Name Time Method Number of Participants With Adverse Events (AEs), Serious AEs, and Infusion/Administration-related Reactions (IRRs/ARRs) From day of first rituximab induction dose up to day of disease progression, or discontinuation of treatment for any reason (up to approximately 87 months) An adverse event is any untoward medical occurrence in a subject administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events. Not all AEs were followed up for the randomized Observation arm. Only Serious AEs and AE grade 3-5 (obtained retrospectively) were collected for this arm. Therefore arms are not comparable overall.
Overall Survival From day of first rituximab induction dose up to death (up to approximately 87 months) Overall survival from first induction treatment (OSRegist) is defined as the time from date of first rituximab induction dose to the date of death, irrespective of cause. One participant died in Induction before randomization and one participant died in Maintenance II Observation arm due to an SAE and were not considered in the analysis as no death page was completed.
Time to Next Lymphoma Treatment (TNLT) From day of first rituximab induction dose up to any new lymphoma treatment (up to approximately 87 months) Time to next lymphoma treatment (TNLT) is defined as the time from date of first rituximab induction dose to the date date of first documented intake of any new antilymphoma treatment (chemotherapy, radiotherapy, immunotherapy, etc.).
Maintenance I: Percentage of Participants With Conversion of PR to CR Using 1999 International Working Group (Cheson) Response Criteria for Lymphoma or by the Recommendations for Waldenström's Macroglobulinemia From day of first rituximab induction dose up to end of Maintenance I period (up to approximately 32 months) Progression-free Survival (PFS) Using 1999 International Working Group (Cheson) Response Criteria for Lymphoma or by the Recommendations for Waldenström's Macroglobulinemia From day of first rituximab induction dose up to disease progression or death, whichever occurs first (up to approximately 87 months) Progression free survival from first induction treatment (PFSregist) is defined as the time from date of first rituximab induction dose to the date of first documented disease progression or death by any cause, whichever occurs first.
Maintenance II: Overall Survival From randomization (Maintenance II) up to death (up to approximately 24 months) Overall survival from randomization (OSrand) is defined as the time from date of randomization to the date of death, irrespective of cause.
Event-free Survival (Time to Treatment Failure) Using 1999 International Working Group (Cheson) Response Criteria for Lymphoma or by the Recommendations for Waldenström's Macroglobulinemia From day of first rituximab induction dose up to day of any treatment failure, including disease progression, or discontinuation of treatment for any reason (up to approximately 87 months) Event-Free Survival was measured from the day of first rituximab Induction dose through Maintenance I and Maintenance II rituximab arm until the date of any treatment failure, including disease progression, or discontinuation of treatment for any reason (e.g. disease progression, toxicity, patient preference, initiation of new anti-lymphoma treatment, or death). Treatment discontinuation was considered as an event and was not applicable to the randomized observation arm.
Percentage of Participants With Partial or Complete Tumor Response (PR/CR) Assessment at End of Induction Using 1999 International Working Group Response Criteria for Lymphoma or by the Recommendations for Waldenström's Macroglobulinemia From day of first rituximab induction dose up to end of induction period (up to approximately 8 months) Overall response rate is defined as the proportion of responders at the end of the Induction period. A responder is defined as a participant experiencing either CR or PR tumor response according to the Cheson response criteria for indolent lymphoma or the recommendations for Waldenström's macroglobulinemia.
Trial Locations
- Locations (180)
Tokuda Hospital Sofia; Hematology department
🇧🇬Sofia, Bulgaria
Medizinische Universität Wien; Univ.Klinik für Innere Medizin I - Hämatologie & Hämostaseologie
🇦🇹Wien, Austria
Instituto Nacional de Cancerologia; Hematology
🇨🇴Bogota, Colombia
UMHAT Alexandrovska EAD; Hematology
🇧🇬Sofia, Bulgaria
Centre Hospitalier Uni Ire; Service Des Maladies Du Sang
🇫🇷Angers Cedex 9, France
Hospital de Cancer de Barretos
🇧🇷Barretos, SP, Brazil
Institut d'Hématologie de Basse Normandie
🇫🇷Caen, France
Hopital Uni Ire Dupuytren; Hematologie
🇫🇷Limoges, France
Centro de Pesquisas Oncologicas - CEPON
🇧🇷Florianopolis, SC, Brazil
Lkh-Univ. Klinikum Graz; Klin. Abt. Für Hämatologie
🇦🇹Graz, Austria
Landeskrankenhaus Rankweil; Interne E
🇦🇹Rankweil, Austria
Centro Javeriano de Oncología
🇨🇴Bogota, Colombia
Hospital Solca Quito; Oncologia
🇪🇨Quito, Ecuador
Hospital Solca Portoviejo; Oncologia
🇪🇨Portoviejo, Ecuador
University Hospital Of Patras; Dept. Of Internal Medicine-Hematology Division
🇬🇷Patras, Greece
Centre Hospitalier de La Cote Basque; Hematologie
🇫🇷Bayonne, France
Hopital Claude Huriez; Hematologie
🇫🇷Lille, France
Onkologische Schwerpunktpraxis (Eps-Gmbh)
🇩🇪Jena, Germany
Instituto Damic
🇦🇷Cordoba, Argentina
Gemeinschaftspraxis Dr. Bueckner und Dr. Nueckel
🇩🇪Bochum, Germany
Centro de Tratamento Oncologico - CETRON
🇧🇷Rio de janeiro, RJ, Brazil
CH Henri Mondor; Med Interne Neuro Endocrinologie
🇫🇷Aurillac, France
Dres. Barbara Tschechne Stefanie Luft und Wolf-Oliver Jordan
🇩🇪Lehrte, Germany
Hopital Augustin Morvan; Hematologie
🇫🇷Brest, France
Oncologianova GmbH
🇩🇪Recklinghausen, Germany
Onkologische Schwerpunktpraxis Lübeck
🇩🇪Lübeck, Germany
Hospital Santa Marcelina;Oncologia
🇧🇷Sao Paulo, SP, Brazil
St. Johannes Hospital; Abt. für Hämatologie und Onkologie
🇩🇪Dortmund, Germany
Fundacion Santa Fe de Bogotá
🇨🇴Bogota, Colombia
Hospital Abel Gilbert Ponton; Oncology
🇪🇨Guayaquil, Ecuador
BAG Freiberg-Richter, Jacobasch, Illmer, Wolf; Gemeinschaftspraxis Hämatologie-Onkologie
🇩🇪Dresden, Germany
Hopital Pitie Salpetriere; Hematologie Clinique
🇫🇷Paris, France
University Hospital of Ioannina; Hematology
🇬🇷Ioannina, Greece
Ospedale Santa Chiara; Unita Operativa Di Ematologia
🇮🇹Pisa, Toscana, Italy
Ch Sud Francilien; Hematologie Oncologie
🇫🇷Corbeil Essonnes, France
Hopital Emile Muller; Hematologie
🇫🇷Mulhouse, France
National Institute of Oncology, A Dept of Internal Medicine
🇭🇺Budapest, Hungary
Centre Henri Becquerel; Hematologie
🇫🇷Rouen, France
A.O. Universitaria Policlinico S.Orsola-Malpighi Di Bologna
🇮🇹Bologna, Emilia-Romagna, Italy
Ospedale Maggiore Di Milano; U.O. Ematologia I - Padiglione Marcora
🇮🇹Milano, Lombardia, Italy
Semmelweis University, First Dept of Medicine
🇭🇺Budapest, Hungary
Gemeinschaftspraxis Dr. med. J. Mohm und Dr. med. G. Prange-Krex; Fachaerzte fuer Innere Medizin
🇩🇪Dresden, Germany
Klinikum Darmstadt GmbH; Med. Klinik V; Onkologie & Hämatologie
🇩🇪Darmstadt, Germany
Hopital Hotel Dieu Et Hme; Clinique Dermatologique
🇫🇷Nantes, France
University Hospital of Larissa; Hematology Dept.
🇬🇷Larissa, Greece
Haukeland Universitetssykehus
🇳🇴Bergen, Norway
Asst Grande Ospedale Metropolitano Niguarda; Dipartimento Di Ematologia Ed Oncologia
🇮🇹Milano, Lombardia, Italy
Hospital Universitario de Canarias;servicio de Hematologia
🇪🇸La Laguna, Tenerife, Spain
Hospital Clinico Universitario Virgen de la Victoria; Servicio de Hematologia
🇪🇸Malaga, Spain
Klinikum Grosshadern der LMU
🇩🇪Muenchen, Germany
Hospital de la Santa Creu i Sant Pau; Servicio de Hematologia
🇪🇸Barcelona, Spain
OncoResearch Lerchenfeld GmbH
🇩🇪Hamburg, Germany
Dres. Richard Hansen Susanne Pfitzner-Dempfle und Manfred Reeb
🇩🇪Kaiserslautern, Germany
Hospital Universitario San Cecilio; Servicio de Oncologia
🇪🇸Granada, Spain
The Royal Marsden Hospital; Dept of Medicine
🇬🇧London, United Kingdom
St. Olavs Hospital HF, Kreftavdelingen, Gastrosentret
🇳🇴Trondheim, Norway
Leicester Royal Infirmary; Dept of Haematology
🇬🇧Leicester, United Kingdom
Hospital Quiron de Madrid; Servicio de Hematologia
🇪🇸Pozuelo de Alarcon, Madrid, Spain
St Laszlo Hospital, Pharmacy
🇭🇺Budapest, Hungary
Ospedale Cardarelli; Divisione Di Ematologia
🇮🇹Napoli, Campania, Italy
A.O. Universitaria S. Martino Di Genova; Ematologia 1
🇮🇹Genova, Liguria, Italy
Hospital Duran i Reynals; Servicio de Hematologia
🇪🇸Barcelona, Spain
Seamen' Hospital' Dept. of haematology
🇱🇹Klaipeda, Lithuania
Spitalul Clinic municipal de Urgenta Timisoara; Clinica de Hematologie
🇷🇴Timisoara, Romania
Hacettepe Uni Medical Faculty; Hematology
🇹🇷Ankara, Turkey
Gazi Uni Medical School; Hematology
🇹🇷Ankara, Turkey
Derriford Hospital; Haematology
🇬🇧Plymouth, United Kingdom
Hospital Universitario de Canarias;servicio de Oncologia
🇪🇸La Laguna, Tenerife, Spain
Laenssjukhuset; Medicinkliniken/Hematologsektionen
🇸🇪Halmstad, Sweden
Ospedale San Giovanni; Oncologia
🇨🇭Bellinzona, Switzerland
GATA (Gulhane Military Medical School)
🇹🇷Ankara, Turkey
Complejo Hospitalario de Jaen- Hospital Universitario Medico Quirurgico; Servicio de Hematologia
🇪🇸Jaen, Spain
Hospital Universitari Vall d'Hebron; Servicio de Hematologia
🇪🇸Barcelona, Spain
Västmanlands sjukhus Västerås, Onkologmottagningen
🇸🇪Västerås, Sweden
Södersjukhuset, Medicinkliniken/Sektionen för Hematologi
🇸🇪Stockholm, Sweden
UMHAT Dr Georgi Stranski; Hematology
🇧🇬Pleven, Bulgaria
University of Pecs, I st Dept of Internal Medicine
🇭🇺Pecs, Hungary
Regional Clinical Hospital N.A. Semashko; Hematology
🇷🇺Nizhny Novgorod, Russian Federation
Uni Hospital ; Dept. of Haematol. & Transfusion Medicine
🇸🇰Martin, Slovakia
Tiroler Landeskrankenanstalten Ges.M.B.H.; Innere Medizin Abt. Für Hämatologie & Onkologie
🇦🇹Innsbruck, Austria
Uni of Debrecen; 2Nd Clinic of Internal Medicine
🇭🇺Debrecen, Hungary
Oslo Universitetssykehus HF; Radiumhospitalet
🇳🇴Oslo, Norway
Petrov Research Inst. of Oncology
🇷🇺St Petersburg, Russian Federation
City Clin Hosp n.a. S.P.Botkin
🇷🇺Moscow, Russian Federation
Kepler Universitätskliniken GmbH - Med Campus III; III. Medizinische Abteilung
🇦🇹Linz, Austria
N.N.Blokhin Russian Cancer Research Center; Dept. of Chemotherapy & Hemoblastosis
🇷🇺Moscow, Russian Federation
Universita' Degli Studi La Sapienza-Ist.Di Ematologia; Dip Biot Cel e Ematol
🇮🇹Roma, Lazio, Italy
Uni Di Verona Policlinico G.B. Rossi; Divisione E Cattedra Di Ematologia
🇮🇹Verona, Veneto, Italy
Uni Degli Studi; Dip.Med.Clinica E Sperim. Ematologia
🇮🇹Padova, Veneto, Italy
Institutul Clinic Fundeni; Hematologie
🇷🇴Bucharest, Romania
Spitalul Clinic Coltea; Clinica de Hematologie
🇷🇴Bucuresti, Romania
Spitalul Clinic Judetean de Urgenta Targu-Mures; compartiment Hematologie
🇷🇴Targu-mures, Romania
Leningrad Regional Clinical Hospital
🇷🇺St Petersburg, Russian Federation
SRI of Hematology and Transfusiology
🇷🇺St. Petersburg, Russian Federation
Regional Oncology Center
🇷🇺Chelyabinsk, Russian Federation
Hospital General Universitario de Elche; Servicio de Oncologia
🇪🇸Elche, Alicante, Spain
A.O. Universitaria S. Giovanni Battista-Molinette Di Torino; Ematologia 1
🇮🇹Torino, Piemonte, Italy
Uni Degli Studi Di Bari, Policlinico; Cattedra Di Ematologia,Dipart. Di Medicina Interna E Publica
🇮🇹Bari, Puglia, Italy
Az. Osp. Di Careggi; Divisione Di Ematologia
🇮🇹Firenze, Toscana, Italy
A.O. Universitaria Senese; Ematologia
🇮🇹Siena, Toscana, Italy
Sunderby Sjukhus; Medicinkliniken
🇸🇪Luleå, Sweden
CH Metropole de Savoie
🇫🇷CHAMBERY Cedex, France
Chu Estaing; Hematologie Clinique Adultes
🇫🇷Clermont Ferrand, France
Hopital Henri Mondor
🇫🇷Creteil, France
Chu Site Du Bocage;Hematologie Clinique
🇫🇷Dijon, France
Centre Hospitalier Departemental Les Oudairies
🇫🇷La Roche Sur Yon, France
Hôpital Albert Michallon; Hematologie Clinique
🇫🇷La Tronche, France
Ch Du Mans; Medecine Hematologie Oncologie
🇫🇷Le Mans, France
Hopital Nord; Laboratoire D'Hematologie
🇫🇷Marseille, France
Hôpital Lapeyronie; Hématologie Oncologie Médicale
🇫🇷Montpellier, France
Universitätsklinikum Greifswald Klinik für Innere Medizin C und Poliklinik
🇩🇪Greifswald, Germany
Praxis Dr.med. Jens Uhlig
🇩🇪Naunhof, Germany
Klinik der Uni Regensburg; Hämatologie/Onkologie, Studienzentrale
🇩🇪Regensburg, Germany
Internistisch-Onkologische Gemeinschaftspraxis; Dres. Rohrberg, Hurtz, Schma usw.
🇩🇪Halle, Germany
Dres. Michael Maasberg Marion Schmitz und Maria Theresia Keller
🇩🇪Mayen, Germany
Staedtisches Krankenhaus Muenchen-Schwabing, Haematologie & Onkolgie
🇩🇪München, Germany
Onkologische Gemeinschaftspraxis
🇩🇪Magdeburg, Germany
Dres. Ulrich Banhardt und Thomas Fietz
🇩🇪Singen, Germany
University "Mother Theresa" Hospital Center; Oncology Department
🇦🇱Tirana, Albania
Hospital Privado de Comunidad; Oncology
🇦🇷Mar Del Plata, Argentina
Instituto de Ensino e Pesquisa Sao Lucas - IEP
🇧🇷Sao Paulo, SP, Brazil
Hospital das Clinicas - FMUSP; Hematologia
🇧🇷Sao Paulo, SP, Brazil
Hospital da Cidade de Passo Fundo; Centro de Pesquisa em Oncologia
🇧🇷Passo Fundo, RS, Brazil
Teodoro Maldonado Carbo Hospital; Oncology Service
🇪🇨Guayaquil, Ecuador
Hopital Jean Minjoz; Hematologie
🇫🇷Besancon, France
Kasr Eieny Uni Hospital; Oncology (Nemrock)
🇪🇬Cairo, Egypt
Hopital Andre Mignot; Hematologie - Oncologie
🇫🇷Le Chesnay, France
Hopital Purpan; Hematologie Clinique
🇫🇷Toulouse, France
Centre Antoine Lacassagne;B4 Hematologie Cancerologie
🇫🇷Nice, France
Hopital De Haut Leveque; Hematologie Clinique
🇫🇷Pessac, France
Hamatol Onkol Praxisgemeinschaft Dres H H-D Schick/D Schick
🇩🇪München, Germany
Klinikum rechts der Isar der TU München; III. Medizinischen Klinik (Hämatologie/Onkologie)
🇩🇪München, Germany
Gemeinschaftspraxis Fr. Dr. med. Balser & Hr. Dr. med. Weidenbach
🇩🇪Marburg, Germany
Dres. Andreas Hübner, Andreas Lück und Petra Bruhn
🇩🇪Rostock, Germany
General Hospital of Athens Evangelismos; Hematology
🇬🇷Athens, Greece
Dres. Emil Höring Matthias Respondek und Ulrike Schwinger
🇩🇪Stuttgart, Germany
Laiko General Hospital of Athens; A Propedeutical Clinic of Internal Medicine
🇬🇷Athens, Greece
A.O. Universitaria S. Maria Della Misericordia Di Udine; Oncologia; Clinica Ematologica
🇮🇹Udine, Friuli-Venezia Giulia, Italy
A.O. Universitaria Federico II Di Napoli; Oncologia Ed Endocrinologia Clinica
🇮🇹Napoli, Campania, Italy
Istituto Nazionale Tumori Irccs Fondazione g. Pascale;s.c. Ematologia Oncologica
🇮🇹Napoli, Campania, Italy
A.O.U. Policlinico di Modena-Dipartimento di Medicina Diagnostica, Clinica e di Sanità pubblica
🇮🇹Modena, Emilia-Romagna, Italy
Ospedale Ferrarotto; Divisione Di Ematologia
🇮🇹Via S. Sofia 78, Sicilia, Italy
Ospedale Ca Foncello; Ematologia
🇮🇹Treviso, Veneto, Italy
Azienda Sanitaria Di Bolzano; Ematologia E Centro Trapianto Mid.Osseo
🇮🇹Bolzano, Trentino-Alto Adige, Italy
Helse Stavanger HF, Stavanger Universitetssjukehus; Klinikk for Blod og kreftsykdommer
🇳🇴Stavanger, Norway
County Clinical Emergency Hospital Brasov
🇷🇴Brasov, Romania
Policlinica de Diagnostic Rapid
🇷🇴Brasov, Romania
Rus Med Academy for Postgraduate Education; Oncology Department
🇷🇺Moscow, Russian Federation
Institute of Oncology Ljubljana
🇸🇮Ljubljana, Slovenia
National Oncology Inst. ; Dept. of Haematology
🇸🇰Bratislava, Slovakia
Hospital Univ. Central de Asturias; servicio de Hematologia
🇪🇸Oviedo, Asturias, Spain
Hospital Universitari Germans Trias i Pujol; Servicio de Hematologia
🇪🇸Badalona, Barcelona, Spain
Hospital de Jerez de la Frontera; Servicio de Hematologia
🇪🇸Jerez de La Frontera, Cadiz, Spain
Hospital Universitario Son Espases
🇪🇸Palma De Mallorca, Islas Baleares, Spain
Hospital San Pedro De Alcantara; Servicio de Hematologia
🇪🇸Caceres, Spain
Hospital Arnau de Vilanova (Valencia) Servicio de Hematologia
🇪🇸Valencia, Spain
Complejo Hospitalario Universitario de Ourense, Servicio de Hematologia
🇪🇸Orense, Spain
Hospital Royo Villanova; Servicio de Hematologia
🇪🇸Zaragoza, Spain
Capio, S:T Gorans Hospital; Dept of Medicine
🇸🇪Stockholm, Sweden
Uddevalla Sjukhus; Medicinkliniken
🇸🇪Uddevalla, Sweden
UniversitätsSpital Zürich; Zentrum für Hämatologie und Onkologie, Klinik für Onkologie
🇨🇭Zürich, Switzerland
Marmara University Pendik Training and Research Hospital, Hematology Department
🇹🇷Istanbul, Turkey
Istanbul Uni Capa Medical Faculty; Inst. of Oncology
🇹🇷Istanbul, Turkey
Erciyes Uni ; Hematology
🇹🇷Kayseri, Turkey
Birmingham Heartlands Hospital; Department of Haematology
🇬🇧Birmingham, United Kingdom
Addenbrookes Hospital; Haematology
🇬🇧Cambridge, United Kingdom
Royal Bournemouth General Hospital; Haematology
🇬🇧Bournemouth, United Kingdom
Uni Hospital of Wales; Dept of Haematology
🇬🇧Cardiff, United Kingdom
Kent & Canterbury Hospital; Clinical Haematology
🇬🇧Canterbury, United Kingdom
University College London, Department of Haematology
🇬🇧London, United Kingdom
Royal Liverpool Uni Hospital; Haematology
🇬🇧Liverpool, United Kingdom
Freeman Hospital
🇬🇧Newcastle upon Tyne, United Kingdom
Nottingham City Hospital; Dept of Haematology
🇬🇧Nottingham, United Kingdom
Norfolk & Norwich Hospital; Dept of Haematology
🇬🇧Norwich, United Kingdom
Churchill Hospital; Oxford Cancer and Haematology Centre
🇬🇧Oxford, United Kingdom
Royal Marsden Hospital; Dept. of Medicine
🇬🇧Sutton, United Kingdom
Hospital das Clinicas - UFRGS
🇧🇷Porto Alegre, RS, Brazil
CEMIC Saavedra
🇦🇷Buenos Aires, Argentina
HOSPITAL DE MADRID NORTE SANCHINARRO- CENTRO INTEGRAL ONCOLOGICO CLARA CAMPAL; Servicio Hematologia
🇪🇸Madrid, Spain
Complejo Hospitalario Zamora- H. Virgen de la Concha; Servicio de Hematología
🇪🇸Zamora, Spain