Pomalidomide Plus Anti-CD20 Antibody and Prednisone in Frontline Indolent B-Cell Lymphoma

Inclusion criteria

• Age ≥ 18 years, regardless of sex;
• Confirmed diagnosis of follicular lymphoma (FL), or histopathologically confirmed CD20-positive marginal zone lymphoma (MZL), including extranodal marginal zone lymphoma (MALT), splenic marginal zone lymphoma (SMZL), and nodal marginal zone lymphoma (NMZL),or confirmed diagnosis of indolent mantle cell lymphoma (MCL);
• Patients with a confirmed diagnosis of chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL);
• Confirmed diagnosis of lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia;
• Presence of indications for treatment of indolent B-cell lymphoma;
• No prior systemic antitumor therapy for lymphoma;
• ECOG-PS score 0-2;
• Essentially normal bone marrow hematopoietic function, with routine blood tests as follows: white blood cell count >3000/uL, absolute neutrophil count ≥1.5 × 10^9/L (use of granulocyte colony-stimulating factor is allowed), platelet count ≥75 × 10^9/L (transfusion to reach this minimum platelet count is allowed), and hemoglobin ≥9.0 g/dL (prior red blood cell transfusion or use of recombinant human erythropoietin is allowed). If peripheral blood abnormalities are caused by lymphoma involvement of the bone marrow or spleen, neutrophils≥1.0 × 10^9/L and platelets≥50 × 10^9/L are acceptable (the investigator may determine at his/her discretion whether enrollment is appropriate);
• Normal function of major organs:

• Hepatic function: serum bilirubin ≤2.0 × ULN; serum ALT and AST ≤2.5 × ULN;
• Renal function: creatinine clearance >30 mL/min;
• Expected survival≥3 months as judged by the investigator; Voluntary written informed consent signed before trial screening;

Exclusion criteria

• Current or prior other malignancy, unless curative treatment has been performed and there has been no evidence of recurrence or metastasis within the past 5 years;
• Lymphoma involvement of the central nervous system or transformation to a higher-grade lymphoma;
• Hepatic or renal dysfunction unrelated to lymphoma: alanine aminotransferase (ALT) >3 times the upper limit of normal, aspartate aminotransferase (AST) >3 times the upper limit of normal, total bilirubin (TBIL) >2 times the upper limit of normal, or serum creatinine >1.5 times the upper limit of normal;
• Other serious medical conditions that would affect this study (e.g., uncontrolled diabetes, gastric ulcer, or other serious cardiopulmonary diseases). The investigator has the authority to make this determination;
• Severe or uncontrolled infection;
• Clinically manifest central nervous system dysfunction;
• Major surgery within the past 30 days (excluding lymph node biopsy);
• Pregnant or lactating women, or women of childbearing potential who have not used contraceptive measures;
• Allergy to the study drug; Patients considered unsuitable for enrollment by the investigator.