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CAR T Cell Therapy for Chronic Lymphocytic Leukemia: Successes and Shortcomings
Article

Effect of Lenalidomide Maintenance in Chronic Lymphocytic Leukemia: A Meta-Analysis and Trial-Sequential Analysis

by 1, 2, 3,*,† and 1,*,†
1
Division of Hematology and Oncology Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
2
Department of Neurology, Changhua Christian Hospital, Changhua 500, Taiwan
3
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Curr. Oncol. 2022, 29(6), 4245-4259; https://doi.org/10.3390/curroncol29060339
Received: 23 April 2022 / Revised: 8 June 2022 / Accepted: 9 June 2022 / Published: 14 June 2022
(This article belongs to the Special Issue Chronic Lymphocytic Leukemia: Therapy and Outcome)
Chronic lymphocytic leukemia (CLL) is the most common lymphoproliferative disease in adults. Despite durable responses and sustained remission rates to frontline therapy, CLL is still incurable within standard therapy and eventually relapses. Maintenance therapies aim to achieve deep remission. However, the efficacy and safety of lenalidomide maintenance are still debated. Randomized controlled trials published before March 2022 were retrieved from databases. Primary outcomes were progression-free survival (PFS) and overall survival (OS). Trial sequential analysis examined analytical power in primary outcomes. Secondary outcomes were Grade 3–4 neutropenia, treatment discontinuation (TD), serious adverse events (SAE), and fatal adverse events (FAE). Hazard (HR) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Four articles (733 patients) met the selection criteria. Lenalidomide maintenance was associated with a statistically significant effect in prolonging PFS (HR, 0.43; 95% CI, 0.28–0.68; I2 = 57%) and higher proportion of SAE (OR 4.64; 95% CI 2.96–7.26; I2 = 0%) and exhibited no difference in OS (HR, 0.62; 95% CI, 0.29–1.30; I2 = 52%) observation/placebo. It showed no significant difference compared with observation/placebo regarding Grade 3–4 neutropenia (OR 2.30; 95% CI 0.84–6.28; I2 = 81%), TD (OR 0.76; 95% CI 0.29–1.99; I2 = 84%), and FAE (OR 0.86; 95% CI 0.28–2.63; I2 = 0%). Lenalidomide maintenance can prolong PFS in CLL. Further studies should verify its effect on OS. View Full-Text
Keywords: chronic lymphocytic leukemia; lenalidomide; maintenance therapy; meta-analysis chronic lymphocytic leukemia; lenalidomide; maintenance therapy; meta-analysis
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MDPI and ACS Style

Yu, T.-Y.; Jhou, H.-J.; Chen, P.-H.; Lee, C.-H. Effect of Lenalidomide Maintenance in Chronic Lymphocytic Leukemia: A Meta-Analysis and Trial-Sequential Analysis. Curr. Oncol. 2022, 29, 4245-4259. https://doi.org/10.3390/curroncol29060339

AMA Style

Yu T-Y, Jhou H-J, Chen P-H, Lee C-H. Effect of Lenalidomide Maintenance in Chronic Lymphocytic Leukemia: A Meta-Analysis and Trial-Sequential Analysis. Current Oncology. 2022; 29(6):4245-4259. https://doi.org/10.3390/curroncol29060339

Chicago/Turabian Style

Yu, Tsung-Ying, Hong-Jie Jhou, Po-Huang Chen, and Cho-Hao Lee. 2022. "Effect of Lenalidomide Maintenance in Chronic Lymphocytic Leukemia: A Meta-Analysis and Trial-Sequential Analysis" Current Oncology 29, no. 6: 4245-4259. https://doi.org/10.3390/curroncol29060339

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