Efficacy Of Lenalidomide Monotherapy In Maintenance Therapy Of Chronic Lymphocytic Leukemia:A Meta-Analysis

Objective:To system evaluation overseas the published about efficacy of lenalid-omide monotherapy in maintenance therapy after chemotherapy or chemoi-mmunotherapy for chronic lymphocytic leukemia.Methods:Through Pub Med,Embase,Cochrance,Clinical trial.gov,CNKI,wan-fang data,VIP,CBM and other Chinese and foreign databases,the retrieval time was from establishment to November 2019.Search keywords:chronic lymp-hocytic leukemia or small cell lymphoma;lenalidomide.At the same time,Mesh and free word retrieval are carried out to formulate the retrieval m-ode.To retrieve published literature on clinical trials of lenalidomide for postchemotherapy/chemoimmunotherapy maintenance therapy in CLL/SLL patients.Extracting datas including RI rate、ORR、PFS,and the statistical analysis was carried out with R software version 3.61.Results:A total of 8 literatures and 9 studies were included,and a total of405 CLL/SLL patients were treated with lenalidomide for maintenance.One of the studies was a comparison of lenalidomide and placebo.Pooled response improvement rate was 14.0%(95%CI:6%-25%,I~2=81%),and15%(95%CI:3%-32%,I~2=78%)in initially treated patients with maintenance therapy with lenalidomide,10%(95%CI:0%-26%,I~2=75%)in refractory/recurrent patients with maintenance therapy with lenalidomide.The overall response rate of lenalidomide maintenance therapy for C-LL/SLL patients was 79%(95%CI:51%-96%,I~2=92%).The overall response rate was 97%(95%CI:83%-100%,I~2=61%)for maintenance therapy with le-nalidomide monotherapy in untreated patients,and was 56%(95%CI:0%-100%,I~2=96%)in refractory/relapsed patients treated with lenalidomide mo-notherapy for maintenance.3.The median PFS of leinalidomide maintenance therapy for CLL/S-LL patients was 38.8 months(95%CI:33.6-44.0).The median PFS was 47.1months(95%CT:39.7-54.6)in those patients who haven’t been treated.And that,these patients take part in these trials when they start receiving ch-emotherapy/chemoimmunotherapy.The median PFS was 31.0 months(95%CI:23.9-38.1)for thoes patients who take part in trials when they st-art receiving maintenance therapy.The median PFS in refractory/recurrent CLL/SLL patients was 32.1 months(95%CI:22.1-42.0).Conclusion:1.The maintenance therapy with lenalidomide seems to improve the depth of remission and the overall response rate in CLL/SLL patients,and the effect on untreated patients seems to be better than that on refractory/recurrent patients.2.For patients who cannot tolerate Ibrutinib,lenalidomide is an alter-native treatment option for maintenance therapy after CLL/SLL chemot-herapy or chemoimmunotherapy.