Hc. Schouten et al., The CUP trial: A randomized study analyzing the efficacy of high dose therapy and purging in low-grade non-Hodgkin's lymphoma (NHL), ANN ONCOL, 11, 2000, pp. 91-94
Background: The CUP trial was initiated to analyze the value of high-dose t
herapy and stern-cell transplantation and purging in patients with relapsed
chemosensitive follicular NHL.
Patients and methods: After three cycles of chemotherapy responsive patient
s were randomized to either three more cycles of the same chemotherapy (C),
high-dose therapy followed bq autologous unpurged (U) or purged (P) stem-c
ell transplantation. Purging was performed using a cocktail of monoclonals.
Pretransplant conditioning consisted of cyclophosphamide (60 mg/kg x 2) an
d total body irradiation.
Results: Of the 140 patients registered from 26 centers in Europe, 89 fulfi
lled the criteria for randomization (C: 24, U: 33 and P: 32). Reasons for f
ailure to randomize were: no response (28), persistent marrow infiltration
(4), patient refusal (7), other (7), no data (5). With the current follow u
p (median 26 months from randomization) 16 (66%) in C are known to have pro
gressed or relapsed, in contrast to 13 (39%) of U and 12 (37%) of the P pat
ients (P-value 0.002). Overall survival is premature with the current avail
able data.
Conclusions: Patients in U and P arms had higher progression/relapse-free s
urvival rate. There are some suggestions of some improvement in overall sur
vival rate.