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The most common grade 3-4 AEs related to LR vs. rituximab maintenance were neutropenia 66% vs. 21% (P less then 0.0001) and febrile neutropenia 10% vs. 2% (P=0.05). The overall treatment-related mortality was 1.4%. With 5-year median follow-up, 3-year PFS rates for BR-R, BVR-R, and BR-LR were 77%, 82%, and 76%, respectively (P=0.36) with OS rates of 87%, 90%, and 84%, respectively (P=0.79). For prognostication, CR rate and POD-24 were associated with survival. Conclusions Altogether, neither bortezomib added to BR induction nor lenali