Zanubrutinib, Obinutuzumab and Lenalidomide in Newly Diagnosed Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL)

Inclusion Criteria

• •1） Patients were not categorized by gender ，Age ≥18;
• •2） Confirmed diagnosis of CLL or SLL;
• •3）Patients must be untreated, or not undergoing standardized treatment for the first time, under the following conditions:
• •a) Not treated with fludarabine-containing or bendamustine-containing or rituximab-containing regimens;
• •b) Have not been treated with the application of chlorambucil, or have applied chlorambucil for less than 4 weeks (alone or in combination with adrenal glucocorticoids);
• •(c) If the above treatment has been applied, it must be stopped for 2 weeks before enrollment in the group to start the treatment.
• •4） Indications for treatment of CLL/SLL include, inter alia (at least one of the following conditions is met)
• •1. Evidence of progressive bone marrow failure: as evidenced by progressive decrease in hemoglobin and/or platelets;
• •2. Giant spleen (e.g., \>6 cm below the left costal margin) or symptomatic splenomegaly;
• •3. Giant lymph node enlargement (e.g., longest diameter \>10 cm) or symptomatic lymph node enlargement;
• •4. Progressive lymphocytosis, e.g., \>50% lymphocytosis within 2 months, or lymphocyte doubling time (LDT) \<6 months. When initial lymphocytes are \<30 x 10\^9/L, LDT alone cannot be used as a therapeutic indication;
• •5. CLL/SLL resulting in symptomatic organ dysfunction (e.g., skin, kidney, lung, spine, etc.)
• •6. Autoimmune hemolytic anemia (AIHA) and/or immune thrombocytopenia (ITP) that does not respond well to corticosteroids or other standard therapy;
• •7. Presence of at least one of the following disease-related symptoms: i) weight loss ≥10% without apparent cause within the previous 6 months; ii) severe fatigue (e.g., ECOG physical status ≥2; inability to perform routine activities); iii) temperature \>38°C for ≥2 weeks without evidence of infection; iv) nocturnal night sweats for \>1 month without evidence of infection;
• •5） ECOG≤2
• •6\) Major organ function within 7 days prior to treatment, meet the following criteria: routine blood test criteria: platelets ≥30×10\^9/L; biochemical tests need to meet the following criteria: total bilirubin (TBIL) ≤1.5 times the upper limit of normal (ULN); alanine aminotransferase (ALT) and aspartate aminotransferase AST ≤2.5 ULN; creatinine clearance ≥ 30 ml/min; and cardiac Doppler ultrasound assessment: left ventricular ejection fraction (LVEF) ≥ low limit of normal (50%);
• •7\) Male and female patients of childbearing age agree to use reliable contraception throughout the study period and for 4 weeks after the end of study treatment;
• •8\) Patients need to have an expected survival of ≥ 6 months;
• •9\) Patients need to voluntarily participate in this study by signing an informed consent form.