Radomisation Patients will randomly be assigned to either one of the two arms, that is, with and without CDL. To ensure that all patients in each of the arms are represented and equally balanced out in both arms, the study will use stratified randomization where each of the categories of patients at the start of the study will form the strata on interest. Within each stratum, the patients will randomly assigned to C4L or no C4L. Randomization lists wil be generated by an independent statistician and kept under lock and key in the two sites.