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BLR-CLL is a combination chemoimmunotherapy regimen consisting of the alkylating agent bendamustine, the immunomodulatory drug lenalidomide, and the anti-CD20 monoclonal antibody rituximab. Developed as an investigator-initiated regimen at Georgetown University, it was evaluated in a Phase I dose-escalation study for patients with relapsed or refractory B-cell lymphoid malignancies, including chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL). The regimen combines the cytotoxic effects of bendamustine-induced DNA cross-linking with the immunomodulatory, anti-proliferative, and anti-angiogenic activities of lenalidomide, alongside rituximab-mediated antibody-dependent cellular cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC) against CD20-positive B-cells.
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