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August 23, 2026Blood Cancer JournalOpen Access

Lenalidomide and rituximab for relapsed/refractory follicular lymphoma: a systematic review and meta-analysis

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Authors

SGSarah Matarasso GreenfeldRORakan OkdeMSMark Sorin

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Overview

Meta-analysis reveals high efficacy of lenalidomide-rituximab in relapsed or refractory follicular lymphoma, indicating triplet regimens boost complete response at the cost of increased toxicity.

Key Points

  • Clarify the overall efficacy of lenalidomide plus anti-CD20 monoclonal antibodies and determine the therapeutic benefit and toxicity of triplet combinations in relapsed or refractory follicular lymphoma.
  • Systematic review and meta-analysis of 24 treatment arms encompassing 2,245 patients with relapsed or refractory follicular lymphoma.
  • Evaluated lenalidomide plus rituximab or anti-CD20 antibodies (63% of patients) versus triplet regimens adding a third agent (37% of patients).
  • Lenalidomide plus anti-CD20 antibodies achieved an overall response rate of 75.9% (95% CI 72.1–79.3, p = 0.0092; I² = 53.5%) and a complete response rate of 39.6% (95% CI 32.4–47.3, p < 0.0001, I² = 73.2%).
  • Complete response rates were lower in rituximab-refractory cohorts compared to rituximab-sensitive cohorts (28.6% vs. 42.9%), whereas the number of prior therapy lines did not alter overall response.
  • Triplet regimens produced significantly higher complete response rates and longer 1- and 2-year progression-free survival than doublets, but carried an increased incidence of grade ≥3 toxicities.

Cite This Study

Greenfeld et al. (2026) studied this question.

synapsesocial.com/papers/6a8aade47677a34114446711https://doi.org/10.1038/s41408-026-01608-6
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