The CUP trial

a randomized study analyzing the efficacy of high dose therapy and purging in low-grade non-Hodgkin's lymphoma (NHL)

H C Schouten, S Kvaloy, M Sydes, W Qian, Peter Fayers

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

BACKGROUND: The CUP trial was initiated to analyze the value of high-dose therapy and stem-cell transplantation and purging in patients with relapsed chemosensitive follicular NHL. PATIENTS AND METHODS: After three cycles of chemotherapy responsive patients were randomized to either three more cycles of the same chemotherapy (C), high-dose therapy followed by autologous unpurged (U) or purged (P) stem-cell transplantation. Purging was performed using a cocktail of monoclonals. Pretransplant conditioning consisted of cyclophosphamide (60 mg/kg x 2) and total body irradiation. RESULTS: Of the 140 patients registered from 26 centers in Europe, 89 fulfilled the criteria for randomization (C: 24, U: 33 and P: 32). Reasons for failure to randomize were: no response (28), persistent marrow infiltration (4), patient refusal (7), other (7), no data (5). With the current follow up (median 26 months from randomization) 16 (66%) in C are known to have progressed or relapsed, in contrast to 13 (39%) of U and 12 (37%) of the P patients (P-value 0.002). Overall survival is premature with the current available data. CONCLUSIONS: Patients in U and P arms had higher progression/relapse-free survival rate. There are some suggestions of some improvement in overall survival rate.
Original languageEnglish
Pages (from-to)91-94
Number of pages4
JournalAnnals of Oncology
Volume11
Issue numberSuppl 1
Publication statusPublished - 2000

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Non-Hodgkin's Lymphoma
Stem Cell Transplantation
Random Allocation
Therapeutics
Survival Rate
Drug Therapy
Follicular Lymphoma
Whole-Body Irradiation
Cyclophosphamide
Disease-Free Survival
Bone Marrow
Recurrence
Survival

Keywords

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols
  • Bone Marrow Purging
  • Combined Modality Therapy
  • Confidence Intervals
  • Disease-Free Survival
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Great Britain
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Lymphoma, Non-Hodgkin
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Survival Analysis
  • Transplantation, Autologous
  • Treatment Outcome
  • follicular lymphoma
  • high-dose therapy
  • purging
  • randomized trial

Cite this

The CUP trial : a randomized study analyzing the efficacy of high dose therapy and purging in low-grade non-Hodgkin's lymphoma (NHL). / Schouten, H C; Kvaloy, S; Sydes, M; Qian, W; Fayers, Peter.

In: Annals of Oncology, Vol. 11 , No. Suppl 1, 2000, p. 91-94.

Research output: Contribution to journalArticle

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AU - Qian, W

AU - Fayers, Peter

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N2 - BACKGROUND: The CUP trial was initiated to analyze the value of high-dose therapy and stem-cell transplantation and purging in patients with relapsed chemosensitive follicular NHL. PATIENTS AND METHODS: After three cycles of chemotherapy responsive patients were randomized to either three more cycles of the same chemotherapy (C), high-dose therapy followed by autologous unpurged (U) or purged (P) stem-cell transplantation. Purging was performed using a cocktail of monoclonals. Pretransplant conditioning consisted of cyclophosphamide (60 mg/kg x 2) and total body irradiation. RESULTS: Of the 140 patients registered from 26 centers in Europe, 89 fulfilled the criteria for randomization (C: 24, U: 33 and P: 32). Reasons for failure to randomize were: no response (28), persistent marrow infiltration (4), patient refusal (7), other (7), no data (5). With the current follow up (median 26 months from randomization) 16 (66%) in C are known to have progressed or relapsed, in contrast to 13 (39%) of U and 12 (37%) of the P patients (P-value 0.002). Overall survival is premature with the current available data. CONCLUSIONS: Patients in U and P arms had higher progression/relapse-free survival rate. There are some suggestions of some improvement in overall survival rate.

AB - BACKGROUND: The CUP trial was initiated to analyze the value of high-dose therapy and stem-cell transplantation and purging in patients with relapsed chemosensitive follicular NHL. PATIENTS AND METHODS: After three cycles of chemotherapy responsive patients were randomized to either three more cycles of the same chemotherapy (C), high-dose therapy followed by autologous unpurged (U) or purged (P) stem-cell transplantation. Purging was performed using a cocktail of monoclonals. Pretransplant conditioning consisted of cyclophosphamide (60 mg/kg x 2) and total body irradiation. RESULTS: Of the 140 patients registered from 26 centers in Europe, 89 fulfilled the criteria for randomization (C: 24, U: 33 and P: 32). Reasons for failure to randomize were: no response (28), persistent marrow infiltration (4), patient refusal (7), other (7), no data (5). With the current follow up (median 26 months from randomization) 16 (66%) in C are known to have progressed or relapsed, in contrast to 13 (39%) of U and 12 (37%) of the P patients (P-value 0.002). Overall survival is premature with the current available data. CONCLUSIONS: Patients in U and P arms had higher progression/relapse-free survival rate. There are some suggestions of some improvement in overall survival rate.

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