Combination of Zanubrutinib, Rituximab and Venetoclax in Patients With Previously Untreated Follicular Lymphoma

Inclusion Criteria: * A diagnosis of follicular lymphoma (grades 1, 2, or 3a), untreated * Stage II, III, or IV disease * Able and willing to provide written informed consent and to comply with the study protocol * at least one measurable disease * Must be in need of therapy as evidenced by at least one of the following criteria: * Presence of at least one B symptom: * Fever (\> 38 Celsius \[C\]) not due to infectious etiology * Night sweats * Weight loss \> 10% in the past 6 months * Fatigue due to lymphoma * Splenomegaly (\> 13 cm) * Compression syndrome (ureteral, orbital, gastrointestinal) * Any of the following cytopenias, due to lymphoma: * Hemoglobin ≤ 10 g/dL * Platelets ≤ 100 x 10\^9/L * Absolute neutrophil count (ANC) \< 1.5 x 10\^9/L * Pleural or peritoneal effusion * Lactate dehydrogenase (LDH) \> upper limit of normal (ULN) or beta (B)2 microglobulin \> ULN * Other lymphoma-mediated symptoms as determined by the treating physician Exclusion Criteria: * ECOG≤ 2 * Absolute neutrophil count (ANC) \> 1.0 x 10\^9/L * Platelet count \> 50 x 10\^9/L * Prothrombin time (PT)/international normal ratio (INR) \< 1.5 x (upper limit of normal) ULN and partial thromboplastin time (PTT) (activated partial thromboplastin time \[aPTT\]) \< 1.5 x ULN (unless abnormalities are unrelated to coagulopathy or bleeding disorder). When treated with warfarin or other vitamin K antagonists, then INR ≤ 3.0) * Serum aspartate transaminase (AST) and alanine transaminase (ALT) \< 3 x upper limit of normal (ULN) * Creatinine clearance \> 30 ml/min calculated by modified Cockcroft-Gault formula * Bilirubin \< 1.5 x ULN unless bilirubin is due to Gilbert's syndrome, documented liver involvement with lymphoma, or of non-hepatic origin, in which case bilirubin should not exceed 3 g/dL * Women of childbearing potential must have a negative serum (beta-human chorionic gonadotropin \[B-hCG\]) pregnancy test at screening. Women who are pregnant or breastfeeding are ineligible for this study Exclusion Criteria: * Known active central nervous system lymphoma or leptomeningeal disease * Follicular lymphoma with evidence of diffuse large B-cell transformation * Grade 3b follicular lymphoma * Any prior history of other malignancy besides follicular lymphoma * History of severe allergic or anaphylactic reactions to monoclonal antibody therapy * Patients who have undergone major surgery within 14 days * The researchers believe that it is not advisable for the participant to take part in this trial.