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Efficacy of lenalidomide in relapsed/refractory chronic lymphocytic leukemia patient: a systematic review and meta-analysis

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Abstract

Therapeutic results of relapsed/refractory chronic lymphocytic leukemia (CLL) are very disappointing at present. Lenalidomide has been proved to be effective for relapsed/refractory CLL as a single agent or in combination with various chemo-immunotherapeutic regimens. However, current clinical experience in its usage is still limited. Because of existing considerable variability in different studies, a systematic review and meta-analysis was conducted to describe overall response rate (ORR) of lenalidomide in patients with relapsed/refractory CLL. Pooled estimate of cumulative prevalence of total ORR was 42.23 % (95 % confidence interval [CI], 32.49–52.61 %), while pooled ORR in regimen with lenalidomide plus anti-CD20 monoclonal antibody (mAbs) and lenalidomide mono-therapy were 60.01 % (95 % CI, 53.86–65.86 %) and 24.38 % (95 % CI, 16.15–35.06 %), respectively. There was no significant difference between L + R (lenalidomide plus rituximab) group and L + O (lenalidomide plus ofatumumab) group, with pooled ORR of 66.38 % (95 % CI, 57.96–73.87 %) and 57.40 % (95 % CI, 46.46–67.65 %), respectively. When co-administrated with anti-CD20 mAbs, dosage of lenalidomide was not the key factor of ORR in combination therapy. Pooled ORR of patient with high-risk cytogenetic in L + anti-CD20 mAbs group was 56.74 % (95 % CI, 45.53–67.30 %). In comparison with patients without high-risk cytogenetic receiving the same treatment regimen, no significant difference was observed, with relative risk (RR) of 0.87 (95 % CI 0.68–1.11). Our finding demonstrated that lenalidomide plus anti-CD20 mAbs could be an efficient therapy regimen for relapsed/refractory CLL patients, especially for those with high-risk cytogenetic factor.

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Authors and Affiliations

  1. Department of Pharmacy, Assessment of Clinical Drugs Risk and Individual Application Key Laboratory, Beijing Hospital, Beijing, 100730, China

    Liang Liang, Ming Zhao, Yuan-chao Zhu, Xin Hu & Li-ping Yang

  2. Department of Hematology, Beijing Hospital, Beijing, 100730, China

    Hui Liu

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Authorship Contributions

L.L, M.Z., and H.L participated in the design of the study. L.Y. helped correct search strategy. L.L. and M.Z did the data search and extracted data. Y. Z and L.L. performed all statistical analyses, and L.L. wrote the paper, which was reviewed and edited by X.H, L.Y., and H.L.

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Liang, L., Zhao, M., Zhu, Yc. et al. Efficacy of lenalidomide in relapsed/refractory chronic lymphocytic leukemia patient: a systematic review and meta-analysis. Ann Hematol 95, 1473–1482 (2016). https://doi.org/10.1007/s00277-016-2719-6

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  • DOI: https://doi.org/10.1007/s00277-016-2719-6

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