Zanubrutinib, Rituximab, and Lenalidomide in the First-Line Treatment of Marginal Zone Lymphoma

Inclusion Criteria: 1. 18-75 years 2. Histologically confirmed MZL in untreated stage III or IV and needed for therapy as determined by the treating physician 3. ECOG performance status 0-2 4. Expected survival ≥ 6 months 5. Adequate hematologic and organ function: absolute neutrophil count ≥1,000/mm3 (independent of growth factor support), platelet counts ≥75,000/mm3, serum aspartate transaminase or alanine transaminase less than 2.5 times the upper limit of normal (ULN), serum creatinine ≤1.5×ULN, and bilirubin ≤1.5×ULN unless bilirubin is due to Gilbert's syndrome, documented liver involvement with lymphoma, or of nonhepatic origin, in which case bilirubin should not exceed 3 g/dL, left ventricular ejection fraction (LVEF) of the heart≥ 50% 6. Women of childbearing potential and men who were sexually active were required to be practicing a highly effective method of birth control during and after the study 7. No history of other malignant tumors 8. At least one measurable lesion with a longest diameter of ≥ 1.5 cm or measurable lesions of extranodal lesions ≥ 1.0 cm. 9. Able to understand the study and provide signed Informed Consent Form Exclusion Criteria: 1. Pregnant or lactating women 2. Active central nervous system lymphoma 3. Previous anti-tumor treatment 4. A severe immediate-type hypersensitivity reaction history for any of the drugs used in this study 5. History of stroke or intracranial hemorrhage within 6 months before study entry 6. Received a live attenuated vaccine within 4 weeks prior to enrollment History of human immunodeficiency virus, or active hepatitis C virus, or active hepatitis B virus infection, or any uncontrolled active systemic infection 7. Clinically significant cardiovascular disease such as uncontrolled or symptomatic arrhythmias, congestive heart failure, or myocardial infarction within 6 months of screening, or any class 3 (moderate) or class 4 (severe) cardiac disease as defined by the New York Heart Association Functional Classification 8. Other serious medical conditions that might have an impact on this study