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. 2022 Sep 16;11(1):57.
doi: 10.1186/s40164-022-00314-w.

Rituximab, lenalidomide and BTK inhibitor as frontline treatment for elderly or unfit patients with diffuse large B-cell lymphoma: a real-world analysis of single center

Yanan Zhu #  1   2   3   4 , Xiang Zhang #  1   2   3   4 , Juying Wei  1   2   3   4 , Chunmei Yang  1   2   3   4 , Hongyan Tong  1   2   3   4 , Wenyuan Mai  1   2   3   4 , Min Yang  1   2   3   4 , Jiejing Qian  1   2   3   4 , Liping Mao  1   2   3   4 , Haitao Meng  1   2   3   4 , Jie Jin  5   6   7   8 , Wenjuan Yu  9   10   11   12
Affiliations

Rituximab, lenalidomide and BTK inhibitor as frontline treatment for elderly or unfit patients with diffuse large B-cell lymphoma: a real-world analysis of single center

Yanan Zhu et al. Exp Hematol Oncol. .

Abstract

The combination of rituximab, lenalidomide, and Bruton's tyrosine kinase inhibitor (BTKi) ibrutinib, followed by chemotherapy, has shown high efficacy in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) in Smart Start trial. We aimed to evaluate the efficacy, safety of SMART (rituximab + lenalidomide + BTKi) regimen and SMART-START regimen as a first-line treatment in elderly or unfit DLBCL patients. 31 patients were included, 17 used SMART regimen, with median age 82 years, 14 unfit patients received SMART-START regimen. 14/16 (87.5%) patients in SMART group achieved overall response (OR), with 10/16 (62.5%) achieved complete response (CR). 12/13 (92.3%) patients in SMART-START group achieved OR, with 8/13 (61.5%) achieved CR. With a median follow-up of 15.4 (3-29.1) months, median progression-free survival (PFS) and overall survival (OS) have not been reached, 1-year PFS was 81% in SMART group and 84% in SMART-START group. Common grade 3-4 adverse events (AEs) during SMART regimen were neutropenia (8 [25.8%]), infection (6 [19.4%]) and skin rash (3 [9.7%]). Our study shows that SMART regimen is an effective and safe therapy for elderly DLBCL patients, and SMART-START regimen can be used in unfit patients who could not tolerate intensive chemotherapy in the onset.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Survival outcomes after a median follow-up of 15.4 months. A Median progression-free survival time in all patients was not reached, 1-year PFS was 81% in SMART group and 84% in SMART–START group. B Median overall survival time in all patients was not reached, 1-year overall survival was 89% in SMART group and 91% in SMART–START group
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