Phase 3 Study of Carfilzomib, Melphalan, Prednisone vs Bortezomib, Melphalan, Prednisone in Newly Diagnosed Multiple Myeloma
- Conditions
- Multiple Myeloma
- Interventions
- Registration Number
- NCT01818752
- Lead Sponsor
- Amgen
- Brief Summary
The primary objective was to compare the progression-free survival of transplant ineligible patients newly diagnosed with multiple myeloma who were treated with carfilzomib, melphalan and prednisone (CMP) or with Velcade® (bortezomib), melphalan and prednisone (VMP).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 955
-
Newly diagnosed symptomatic multiple myeloma (per International Myeloma Working Group [IMWG] diagnostic criteria)
-
Transplant ineligibility
-
Measurable disease, as defined by 1 or more of the following (assessed within 21 days prior to randomization):
- Serum M-protein ≥ 0.5 g/dL, or
- Urine M-protein ≥ 200 mg/24 hours, or
- In subjects without detectable serum or urine M-protein, serum free light chain (SFLC) > 100 mg/L (involved light chain) and an abnormal kappa lambda ratio (SFLC kappa lambda ratio < 0.26 or > 1.65)
-
No prior treatment for multiple myeloma
-
Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Multiple myeloma of IgM (immunoglobulin M) subtype
- Glucocorticoid therapy within 14 days prior to randomization that equals or exceeds a cumulative dose of 160 mg of dexamethasone
- POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes)
- Plasma cell leukemia (> 2.0 × 10^9/L circulating plasma cells by standard differential)
- Waldenström macroglobulinemia (WM)
- Known amyloidosis
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Carfilzomib, Melphalan, Prednisone Melphalan Participants received carfilzomib administered in combination with melphalan and prednisone for nine 42-day cycles. Carfilzomib was administered as an intravenous (IV) infusion on days 1, 2, 8, 9, 22, 23, 29, and 30 of each 42-day cycle. The carfilzomib dose was at 20 mg/m² on cycle 1, days 1 and 2 followed by 36 mg/m² thereafter. On days 1 to 4, melphalan was administered at 9 mg/m² and prednisone was administered at 60 mg/m². Carfilzomib, Melphalan, Prednisone Carfilzomib Participants received carfilzomib administered in combination with melphalan and prednisone for nine 42-day cycles. Carfilzomib was administered as an intravenous (IV) infusion on days 1, 2, 8, 9, 22, 23, 29, and 30 of each 42-day cycle. The carfilzomib dose was at 20 mg/m² on cycle 1, days 1 and 2 followed by 36 mg/m² thereafter. On days 1 to 4, melphalan was administered at 9 mg/m² and prednisone was administered at 60 mg/m². Carfilzomib, Melphalan, Prednisone Prednisone Participants received carfilzomib administered in combination with melphalan and prednisone for nine 42-day cycles. Carfilzomib was administered as an intravenous (IV) infusion on days 1, 2, 8, 9, 22, 23, 29, and 30 of each 42-day cycle. The carfilzomib dose was at 20 mg/m² on cycle 1, days 1 and 2 followed by 36 mg/m² thereafter. On days 1 to 4, melphalan was administered at 9 mg/m² and prednisone was administered at 60 mg/m². Bortezomib, Melphalan, Prednisone Melphalan Participants received bortezomib in combination with melphalan and prednisone for nine 42-day cycles. Bortezomib was administered either IV or subcutaneously at 1.3 mg/m² during cycles 1 to 4 on days 1, 4, 8, 11, 22, 25, 29, and 32 followed by 1.3 mg/m² during cycles 5 to 9 on days 1, 8, 22, and 29. On days 1 to 4 of each cycle, melphalan was administered at 9 mg/m² and prednisone was administered at 60 mg/m². Bortezomib, Melphalan, Prednisone Bortezomib Participants received bortezomib in combination with melphalan and prednisone for nine 42-day cycles. Bortezomib was administered either IV or subcutaneously at 1.3 mg/m² during cycles 1 to 4 on days 1, 4, 8, 11, 22, 25, 29, and 32 followed by 1.3 mg/m² during cycles 5 to 9 on days 1, 8, 22, and 29. On days 1 to 4 of each cycle, melphalan was administered at 9 mg/m² and prednisone was administered at 60 mg/m². Bortezomib, Melphalan, Prednisone Prednisone Participants received bortezomib in combination with melphalan and prednisone for nine 42-day cycles. Bortezomib was administered either IV or subcutaneously at 1.3 mg/m² during cycles 1 to 4 on days 1, 4, 8, 11, 22, 25, 29, and 32 followed by 1.3 mg/m² during cycles 5 to 9 on days 1, 8, 22, and 29. On days 1 to 4 of each cycle, melphalan was administered at 9 mg/m² and prednisone was administered at 60 mg/m².
- Primary Outcome Measures
Name Time Method Progression-Free Survival (PFS) From randomization until the data cut-off date of 15 July 2016; median follow-up time for PFS was 21.6.and 22.2 months in the bortezomib and carfilzomib arms respectively. Progression-free survival was defined as the time from randomization to the earlier of documented disease progression or death due to any cause. PFS was analyzed using Kaplan-Meier methods. The duration of PFS was censored for participants with no baseline and/or post-baseline disease assessments, who started a new anti-cancer therapy before documentation of disease progression or death, death or disease progression after missed disease assessment of 100 consecutive days or longer, or who were alive without documentation of disease progression before the data cutoff date, including lost to follow-up prior to disease progression.
Participants were evaluated for disease response and progression according to the International Myeloma Working Group Uniform Response Criteria (IMWG-URC), determined centrally using a validated computer algorithm in a blinded manner.
- Secondary Outcome Measures
Name Time Method Overall Survival (OS) From randomization until the data cut-off date of 15 July 2016; median follow-up time for OS was 22.2 and 22.5 months in the bortezomib and carfilzomib arms respectively. Overall survival (OS) was defined as the time from randomization to the date of death (whatever the cause). Participants who were alive or lost to follow-up as of the data analysis cut-off date were censored on the date the patient was last known to be alive.
Median overall survival was estimated using the Kaplan-Meier method.Overall Response Rate Disease response was assessed every 3 weeks during the first 54 weeks and every 6 weeks thereafter until PD or the data cut-off date of 15 July 2016; median follow-up time was 21.6.and 22.2 months in the bortezomib and carfilzomib arms respectively. Disease response was evaluated according to the IMWG-URC using a validated computer algorithm. Overall response was defined as the percentage of participants with a best overall response of stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR).
sCR: As for CR, normal serum free light chain (SFLC) ratio and no clonal cells in bone marrow (BM).
CR: No immunofixation on serum and urine, disappearance of any soft tissue plasmacytomas and \< 5% plasma cells in BM biopsy; VGPR: Serum and urine M-protein detectable by immunofixation but not electrophoresis or ≥ 90% reduction in serum M-protein with urine M-protein \<100 mg/24 hours. A ≥ 50% reduction in the size of soft tissue plasmacytomas if present at baseline.
PR: ≥ 50% reduction of serum M-protein and reduction in urine M-protein by ≥ 90% or to \< 200 mg/24 hours. A ≥ 50% reduction in the size of soft tissue plasmacytomas if present at baseline.Complete Response Rate Disease response was assessed every 3 weeks during the first 54 weeks and every 6 weeks thereafter until PD or the data cut-off date of 15 July 2016; median follow-up time was 21.6.and 22.2 months in the bortezomib and carfilzomib arms respectively. Complete response rate was defined as the percentage of participants in each treatment group who achieved a sCR or CR per the IMWG-URC as their best response.
sCR: As for CR, normal serum free light chain (SFLC) ratio and no clonal cells in bone marrow (BM).
CR: No immunofixation on serum and urine, disappearance of any soft tissue plasmacytomas and \< 5% plasma cells in BM biopsy.Percentage of Participants With ≥ Grade 2 Peripheral Neuropathy From the first dose of any study drug up to 30 days after the last dose of any study drug as of the data cut-off date of 15 July 2016; median duration of treatment was 52 weeks in both treatment groups. Neuropathy events were defined as Grade 2 or higher peripheral neuropathy as specified by peripheral neuropathy Standardised Medical Dictionary for Regulatory Activities (MedDRA) Query, narrow (scope) (SMQN) terms.
Peripheral neuropathy was assessed by neurologic exam and graded according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 4.03:
Grade 1: Asymptomatic; Grade 2: Moderate symptoms, limiting instrumental activities of daily living (ADL) Grade 3: Severe symptoms; limiting self-care ADL; Grade 4: Life-threatening consequences, urgent intervention indicated; Grade 5: Death.European Organisation for Research and Treatment of Cancer Quality of Life Core Module (EORTC QLQ-C30) Global Health Status/Quality of Life (QOL) Scores Baseline, weeks 6, 12, 18, 24, 30, 36, 42 and 48 The EORTC QLQ-C30 is a validated self-rating questionnaire including 30 items used to assess the overall quality of life in cancer patients.
It consists of 15 domains: 1 global health status (GHS) scale, 5 functional scales (Physical, Role, Cognitive, Emotional, Social), and 9 symptom scales/items (Fatigue, Nausea and Vomiting, Pain, Dyspnea, Sleep Disturbance, Appetite Loss, Constipation, Diarrhea, Financial Impact).
The EORTC QLQ-C30 Global Health Status/QOL scale was scored between 0 and 100, with higher scores indicating better Global Health Status/QOL.Number of Participants With Adverse Events From the first dose of any study drug up to 30 days after the last dose of any study drug as of the data cut-off date of 15 July 2016; median duration of treatment was 52 weeks in both treatment groups. Adverse events (AEs)were graded using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 4.03, where GRADE 1 = Mild; GRADE 2 = Moderate; GRADE 3 = Severe; GRADE 4 = Life-threatening; GRADE 5 = Fatal.
A serious adverse event is an adverse event that met 1 or more of the following criteria:
* Death
* Life-threatening
* Required inpatient hospitalization or prolongation of an existing hospitalization
* Resulted in persistent or significant disability/incapacity
* Congenital anomaly/birth defect
* Important medical event that jeopardized the participant and may have required medical or surgical intervention to prevent 1 of the outcomes listed above.
Treatment-related adverse events are adverse events considered related to at least 1 investigational product by the investigator, including those with unknown relationship.
Trial Locations
- Locations (212)
California Cancer Associates for Research & Excellence, Inc. (cCARE)
🇺🇸Fresno, California, United States
Guangdong General Hospital
🇨🇳Guangzhou, Guangdong, China
The Alfred Hospital
🇦🇺Melbourne, Victoria, Australia
Billings Clinic Cancer Center
🇺🇸Billings, Montana, United States
University Multiprofile Hospital for Active Treatment "Sveti Georgi", Plovdiv, Hematology Clinic
🇧🇬Plovdiv, Bulgaria
Ludwig Maximilians University Hospital - Medical Clinic III
🇩🇪Munich, Bavaria, Germany
Tokushima Prefectural Central Hospital
🇯🇵Tokushima, Japan
St. Antonius Ziekenhuis, Department of Hematology
🇳🇱Nieuwegein, Netherlands
Dnipropetrovsk City Multispecialty Clinical Hospital #4, Hematology Centre
🇺🇦Dnipropetrovsk, Ukraine
Maria Sklodowska-Curie Institute of Oncology
🇵🇱Warsaw, Poland
Fundeni Clinical Institute, Hematology Department
🇷🇴Bucharest, Romania
City Clinical Hospital N.A.S.P. Botkin, Department of Bone Marrow Transplantation and Intensive Chemotherapy for Patients with Myeloproliferative Disorders
🇷🇺Moscow, Russian Federation
Kharkiv Regional Clinical Oncology Center, Department of Hematology
🇺🇦Kharkiv, Ukraine
Khmelnytskyi Regional Hospital, Hematology Department
🇺🇦Khmelnytskyi, Ukraine
County Hospital Saint Gallen
🇨🇭Saint Gallen, Switzerland
Chang-Gung Memorial Hospital, Linkou
🇨🇳Tapei, Taiwan
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Taipei Veterans General Hospital
🇨🇳Taipei, Taiwan
Marin Cancer Care
🇺🇸Greenbrae, California, United States
Evanston KelIogg Cancer Center
🇺🇸Evanston, Illinois, United States
UF Health Shands Cancer Hospital
🇺🇸Gainesville, Florida, United States
Innovative Clinical Research Institute
🇺🇸Whittier, California, United States
Maimonides Cancer Center
🇺🇸Brooklyn, New York, United States
Weill Cornell Medical Center
🇺🇸New York, New York, United States
Gabrail Cancer Center Research
🇺🇸Canton, Ohio, United States
Sanatorio Britanico S.A.
🇦🇷Santa Fe, Argentina
Royal Prince Alfred Hospital
🇦🇺Camperdown, New South Wales, Australia
Seattle Cancer Care Alliance
🇺🇸Seattle, Washington, United States
Central Coast Local Health District
🇦🇺North Gosford, New South Wales, Australia
Royal Adelaide Hospital
🇦🇺Adelaide, South Australia, Australia
Border Medical Oncology
🇦🇺Wodonga, Victoria, Australia
Medical University of Innsbruck, University Clinic for Internal Medicine V
🇦🇹Innsbruck, Austria
Royal North Shore Hospital, Haematology Department
🇦🇺New South Wales, Australia
CHR de La Citadelle (ENG: Citadelle Regional Hospital Center)
🇧🇪Liège, Belgium
Fujian Medical University Union Hospital
🇨🇳Fuzhou City, Fujian, China
Military Medical Academy - Multiprofile Hospital for Active Treatment, Sofia, Hematology and Oncology Clinic
🇧🇬Sofia, Bulgaria
Specialized Hospital for Active Treatment of Hematological Diseases, Sofia, Hematology Clinic
🇧🇬Sofia, Bulgaria
CSSS-Champlain-Charles LeMoyne
🇨🇦Greenfield Park, Quebec, Canada
The First Affiliated Hospital of Soochow University
🇨🇳Suzhou, Jiangsu, China
The First Hospital of Jilin University
🇨🇳Changchun, Jilin, China
The First Affiliated Hospital of the Fourth Military Medical University of PLA
🇨🇳Xi'an City, Shanxi, China
Guangzhou First People's Hospital
🇨🇳Guangzhou, Guangdong, China
The First Affiliated Hospital of College of Medicine, Zhejiang University - Dr. Jie Jin
🇨🇳Hangzhou, Zhejiang, China
307 Hospital of PLA
🇨🇳Beijing, China
Peking Union Medical College Hospital
🇨🇳Beijing, China
The First Affiliated Hospital of College of Medicine, Zhejiang University
🇨🇳Hangzhou, Zhejiang, China
Beijing Chao Yang Hospital, Capital Medical University
🇨🇳Beijing, China
Peking University Third Hospital
🇨🇳Beijing, China
Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine
🇨🇳Shanghai, China
Shanghai Changzheng Hospital
🇨🇳Shanghai, China
University Hospital Brno, Department of Internal Hematology and Oncology
🇨🇿Brno, Czechia
Tianjin Medical University Cancer Institute and Hospital
🇨🇳Tianjin, China
Institute on Hematology & Blood Diseases Hospital Chinese Academy of Medical Scicnces & Peking Union Medical University
🇨🇳Tianjin, China
University Hospital Brno, Hospital Pharmacy - Department of Dilution of Cytostasis
🇨🇿Brno, Czechia
University Hospital Hradec Kralove
🇨🇿Hradec Kralove, Czechia
University Hospital Olomouc, 3rd Clinic of Internal Medicine, Nephrology, Rheumatology and Endocrinology
🇨🇿Olomouc, Czechia
CHU de Caen, Côte de Nacre
🇫🇷Caen Cedex 9, France
University Hospital Ostrava, Clinic of Hematooncology of UHO and MFUO
🇨🇿Ostrava, Czechia
General University Hospital Prague, 1st Department of Medicine - Department of Hematology
🇨🇿Prague, Czechia
University Hospital Kralovske Vinohrady - Internal Hematology Clinic
🇨🇿Prague, Czechia
UHC Dijon, Children's Hospital
🇫🇷Dijon, France
CHU Estaing
🇫🇷Clermont-Ferrand, France
CHRU Hopital Huriez, Departement of Hematology
🇫🇷Lille Cedex, France
CHRU Lille Hôpital Claude Huriez
🇫🇷Lille, France
Paoli Calmettes Institute, Department ofHematology 2
🇫🇷Marseille cedex, France
Nantes University Hospital Center
🇫🇷Nantes Cedex 1, France
Centre Hospitalier Regional Universitaire de Nimes, Groupe Hospitalo-Universitaire Caremeau
🇫🇷Nimes cedex 9, France
Hopital Saini Louis, Service d'immuno-Hematologie
🇫🇷Paris, France
Hopital Saint Antoine
🇫🇷Paris, France
Hospital Purpan
🇫🇷Toulouse Cedex 9, France
Hospital Necker
🇫🇷Paris, France
Centre Hospitalier Lyon Sud, Service d'hématologie Clinique
🇫🇷Pierre Bénite, Cedex, France
Hopital Pontchaillou
🇫🇷Rennes Cedex 9, France
South Lyon Hospital Center
🇫🇷Pierre Bénite, cedex, France
CHU de Tours Hopital Bretonneau
🇫🇷Tours Cedex 1, France
University Hospital Cologne
🇩🇪Cologne, Nordrhein-Westfalen, Germany
Freiburg University Medical Center
🇩🇪Freiburg, Baden-Wuerttemberg, Germany
Ulm University Hospital, Center for Internal Medicine, Clinic of Internal Medicine III
🇩🇪Ulm, Baden-Wuerttemberg, Germany
Saarland University Hospital
🇩🇪Homburg / Saar, Saarland, Germany
Group Practice for Hematology and Oncology
🇩🇪Dresden, Germany
Stiftungsklinikum Mittelrhein GmbH, Clinic of Internal Medicine
🇩🇪Koblenz, Germany
University of Athens, Alexandra Hospital
🇬🇷Athens, Greece
St. Istvan and St. Laszlo Hospital of Budapest, Department of Haematology and Stem-cell Transplant
🇭🇺Budapest, Hungary
National Institute of Oncology, Department of Oncology, Internal Medicine "A" and Hematology
🇭🇺Budapest, Hungary
Bekes County Pandy Kalman Hospital 1st Department of Internal Medicine, Hematology
🇭🇺Gyula, Hungary
University of Debrecen, Medical and Health Science Center, Institute for Medicine, Chair of Hematology
🇭🇺Debrecen, Hungary
Soroka University Medical Center
🇮🇱Beer-Sheva, Israel
Rambam Medical Center, Department of Hematology
🇮🇱Haifa, Israel
Ospedali Riuniti di Ancona Umberto I, G.M. Lancisi, G. Salesi
🇮🇹Ancona, Italy
Local NHS of Piacenza Hospital Guglielmo da Saliceto Department Oncology-Hematology, Unit of Hema
🇮🇹Piacenza, Italy
Policlinico Universitario "Umberto I"
🇮🇹Rome, Italy
Nagoya City University Hospital
🇯🇵Nagoya, Aichi, Japan
National Hospitalization Organization Kyushu Cancer Center
🇯🇵Minami-ku, Fukuoka, Japan
Toyohashi Municipal Hospital
🇯🇵Toyohashi, Aichi, Japan
Osaka University Hospital
🇯🇵Suita, Osaka, Japan
National Hospital Organization Okayama Medical Center
🇯🇵Okayama-city, Okayama, Japan
Japanese Red Cross Medical Center
🇯🇵Tokyo, Shibuya-ku, Japan
Tochigi Cancer Center
🇯🇵Utsunomiya, Tochigi, Japan
The Cancer Institute Hospital of Japanese Foundation For Cancer Research
🇯🇵Koto, Tokyo, Japan
National Center for Global Health and Medicine
🇯🇵Shinjuku, Tokyo, Japan
University Hospital, Kyoto Prefectural University of Medicine
🇯🇵Kyoto, Japan
National Hospital Organization Disaster Medical Center
🇯🇵Tachikawa-city, Tokyo, Japan
Pusan National University Hospital
🇰🇷Busan, Korea, Republic of
Chonnam National University Hwasun Hospital
🇰🇷Hwasun-gun, Jeollanam-do, Korea, Republic of
Inje University Busan Paik Hospital
🇰🇷Busan, Korea, Republic of
Kyungpook National University Hospital
🇰🇷Daegu, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
The Catholic University of Korea, Seoul St. Mary's Hospital
🇰🇷Seoul, Korea, Republic of
Gachon University Gil Medical Center
🇰🇷Incheon, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran
🇲🇽Mexico City, Mexico
Vrije Universiteit Medisch Centrum (VUMC), Department of Hematology
🇳🇱Amsterdam, Netherlands
Consultorio Privado del Dr. Guillermo Jose Ruiz y Arguelles
🇲🇽Puebla, Mexico
Fundacion Centro Oncologieo de Integracion Regional - COIR
🇲🇽Mendoza, Mexico
Hospital Universitario "Dr. Jose Eleuterio Gonzalez"
🇲🇽Monterrey, Nuevo Leon, Mexico
Erasmus Medical Center
🇳🇱Rotterdam, Netherlands
Isala Clinics in Zwolle, Department of Oncology
🇳🇱Zwolle, Netherlands
Auckland City Hospital
🇳🇿Auckland, New Zealand
North Shore Hospital
🇳🇿Auckland, New Zealand
Andrzej Mielecki Independent Public Clinical Hospital of Medical University of Silesia in Katowice
🇵🇱Katowice, Poland
City Clinical Hospital #31, Department of Bone Marrow Transplantation and Intensive Chemotherapy for Patients with Myeloproliferative Disorders
🇷🇺St. Petersburg, Russian Federation
Hospital Clinic i Provincial Barcelona
🇪🇸Barcelona, Spain
Hospital Virgen del Rocio University
🇪🇸Sevilla, Spain
Institute of Blood Pathology and Transfusion Medicine
🇺🇦Lviv, Ukraine
Maidstone Hospital, Kent Oncology Centre
🇬🇧Maidstone, Kent, United Kingdom
A. Novak Zakarpattia Regional Clinical Hospital
🇺🇦Uzhgorod, Ukraine
Kent and Canterbury Hospital
🇬🇧Canterbury, Kent, United Kingdom
The Royal Wolverhampton Hospitals NHS Trust, New Cross Hospital
🇬🇧Wolverhampton, United Kingdom
UO Clinica Ematologica, IRCCS A.O.U. San Martino
🇮🇹Genova, GE, Italy
A.O.U. San Luigi Gonzaga
🇮🇹Orbassano, TO, Italy
Maggiore della Carita Hospital of Novara
🇮🇹Novara, Italy
AO Città della Salute e della Scienza di Torino, Division of Hematology
🇮🇹Torino, Italy
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Gyeonggi-do, Korea, Republic of
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
Ospedale S. Eugenio
🇮🇹Roma, Italy
Independent Public Healthcare Facility Municipal Hospital Group, Department of Hematology
🇵🇱Chorzow, Slaskie, Poland
"Prof. Dr. Ion Chiricuta" Institut of Oncology, Hematology Department
🇷🇴Cluj-Napoca, Cluj County, Romania
Wellington Hospital
🇳🇿Wellington, New Zealand
Nicolaus Copernicus Municipal Specialist Hospital, Department of Hematology
🇵🇱Torun, Poland
Iasi Regional Institute for Oncology, Medical Hematology Department
🇷🇴Iasi, Iasi County, Romania
Raigmore Hospital
🇬🇧Inverness, United Kingdom
Hospital Quiron Zaragoza
🇪🇸Zaragoza, Spain
University College London, Cancer Centre
🇬🇧London, United Kingdom
Canterbury Health Laboratories
🇳🇿Christchurch, New Zealand
Nicolaus Copernicus Memorial Provincial Specialist Hospital
🇵🇱Lodz, Poland
Coltea Clinical Hospital, Hematology Department
🇷🇴Bucharest, Romania
Federal State Institution: Russian Research Institute of Hematology and Blood Transfusion under the Federal Agency for High-Tech Medical Care
🇷🇺St. Petersburg, Russian Federation
Independent Public Teaching Hospital No.1 in Lublin, Dept. of Hematology-Oncology
🇵🇱Lublin, Poland
Brasov County Emergency Clinical Hospital, Hematology Department
🇷🇴Brasov, Romania
Independent Public Healthcare Facility University Hospital
🇵🇱Krakow, Poland
Targu-Mures County Emergency Clinical Hospital, Clinic of Hematology and Bone Marrow Transplantation
🇷🇴Targu-Mures, Romania
State Medical Institution: Republican Hospital n a.V.A. Baranov, Department of Hematology
🇷🇺Petrozavodsk, Republic Of Karelia, Russian Federation
Arkhangelsk Regional Clinical Hospital, Department of internal diseases #2
🇷🇺Arkhangelsk, Russian Federation
National University Hospital
🇸🇬Singapore, Singapore
Marmara University Pendik Training and Research Hospital
🇹🇷Istanbul, Pendik, Turkey
Hospital Universitari Germans Trias i Pujol
🇪🇸Badalona, Barselona, Spain
Universitari i Politècnic la Fe de Valencia Consulta Externa de Hematología
🇪🇸Valencia, Spain
Guy's and St. Thomas' NHS Foundation Trust
🇬🇧London, United Kingdom
Hospital Universitario, Salamanca
🇪🇸Salamanca, Spain
Changhua Christian Hospital
🇨🇳Changhua, Taiwan
University Hospital Center Vaudois
🇨🇭Lausanne, Switzerland
Oxford University Hospitals NHS Trust, Churchill Hospital
🇬🇧Oxford, United Kingdom
Ege University Medical Faculty
🇹🇷Izmir, Bornova, Turkey
Ankara University Medical Faculty, Cebeci Research and Application Hospital, Hematology Department
🇹🇷Ankara, Cebeci, Turkey
Northwick Park Hospital
🇬🇧Harrow, Middlesex, United Kingdom
St. Vincent's Hospital Sydney
🇦🇺Darlinghurst, New South Wales, Australia
Calvary Mater Newcastle
🇦🇺Waratah, New South Wales, Australia
Hospital Universitario 12 De Octubre
🇪🇸Madrid, Spain
Centro de educacion medica c investigacioncs clinicas "Norberto Quimo' (CEMIC)
🇦🇷Buenos Aires, Argentina
ZNA, Stuivenberg
🇧🇪Antwerp, Antwerpen, Belgium
University Multiprofile Hospital for Active Treatment "Sveti Georgi", Plovdiv, Oncology and Hematology Clinic
🇧🇬Plovdiv, Bulgaria
St. Vincent's Hospital Melbourne
🇦🇺Fitzroy, Victoria, Australia
Santee Hematology Oncology
🇺🇸Sumter, South Carolina, United States
Vienna Wilhelminen Hospital
🇦🇹Vienna, Austria
Saint Joseph Clinic Arlon, Department of Hematology
🇧🇪Arlon, Luxembourg, Belgium
CHU Mont-Godinne
🇧🇪Yvoir, Belgium
Saint Francis Health System
🇺🇸Greenville, South Carolina, United States
Spartanburg Regional Healthcare System
🇺🇸Spartanburg, South Carolina, United States
Eastern Health - Box Hill Hospital
🇦🇺Box Hill, Victoria, Australia
Elisabeth Linz Hospital
🇦🇹Linz, Austria
Evangelismos Hospital
🇬🇷Athens, Attica, Greece
Kaposi Mor County Teaching Hospital, 2nd Department of Internal Medicine, Hematology
🇭🇺Kaposvar, Hungary
Bacs-Kiskun County Teaching Hospital, II. Department of Internal Medicine
🇭🇺Kecskemet, Hungary
Medical Center of the University of Pecs, 1st Clinic for Internal Medicine
🇭🇺Pecs, Hungary
Multiprofile Hospital for Active Treatment "Sveta Marina", Varna
🇧🇬Varna, Bulgaria
Sutter Gould Medical Foundation
🇺🇸Modesto, California, United States
Ein Kerem Hospital, Department of Hematology
🇮🇱Jerusalem, Israel
The Chaim Sheba Medical Center
🇮🇱Tel Hashomer, Israel
Kyushu University Hospital
🇯🇵Fukuoka, Fukuoka-Ken, Japan
Ogaki Municipal Hospital
🇯🇵Ogaki, Gifu, Japan
Gunma University Hospital
🇯🇵Maebashi, Gunma, Japan
Sapporo Medical University Hospital
🇯🇵Sapporo-shi, Hokkaidou, Japan
Johannes Gutenberg-University Mainz, Medical Clinic and Policlinic III
🇩🇪Mainz, Rhineland-Palatinate, Germany
Independent Public Healthcare Facility of the Ministry of Internal Affairs & Warminsko-Mazurskie Oncology Centre in Olsztyn
🇵🇱Olsztyn, OIsztyn, Poland
Bucharest Emergency University Hospital, Hematology Department
🇷🇴Bucharest, Romania
The Federal State Budget Institute The Nikiforov Russian Center of Emergency and Radiation Medicine the Ministry of Russian
🇷🇺Saint Petersburg, Russian Federation
Poltava M.V. Sklifosovskyi Regional Clinical-Hospital
🇺🇦Poltava, Ukraine
M.I. Pyrohov Vinnytsya Regional Clinical Hospital, Hematology Department
🇺🇦Vinnitsya, Ukraine
O.F. Herbachevskyi Regional Clinical Hospital, Hematology Center
🇺🇦Zhytomyr, Ukraine
National Cancer Center
🇰🇷Goyang-si, Gyeonggi-do, Korea, Republic of
State Medical Institution: First Republican Clinical Hospital under the Ministry of Healthcare of the Republic of Udmurtia
🇷🇺Izhevsk, Russian Federation
Kuohsiung Chang Gung Memorial Hospital
🇨🇳Kaohsiung, Taiwan
State Higher Educational Institution St. Petersburg Pavlov State Medical University
🇷🇺Saint Petersburg, Russian Federation
Singapore General Hospital
🇸🇬Singapore, Singapore
Singapore Oncology Consultants, Gleneagles Hospital
🇸🇬Singapore, Singapore
OncoCare Cancer Center
🇸🇬Singapore, Singapore
China Medical University Hospital
🇨🇳Taichung, Taiwan
Cherkasy Regional Oncology Center
🇺🇦Cherkasy, Ukraine
Kyiv Center for Bone Marrow Transplantation
🇺🇦Kyiv, Ukraine
Institution of the Russian Academy of Medical Sciences Russian Oncological Research Center n.a. N.N.Blokhin under the Russian Academy of Medical Sciences
🇷🇺Moscow, Russian Federation
University Hospital of Navarra
🇪🇸Pamplona, Navarra, Spain