warfarin and Smith-Magenis-Syndrome

A 70-year-old man with relapsed/refractory chronic lymphocytic leukemia has multiple comorbidities including atrial fibrillation (on warfarin for anticoagulation), irritable bowel syndrome, and chronic renal insufficiency. Two years ago, he received bendamustine and rituximab as first-line therapy for chronic lymphocytic leukemia and achieved partial response, but now has relapsed. Fluorescence in situ hybridization cytogenetics reveals deletion 17p. Which novel agent would you recommend for this patient?

Topics: Aged; Antineoplastic Agents; Atrial Fibrillation; Chromosome Deletion; Chromosomes, Human, Pair 17; Comorbidity; Humans; Irritable Bowel Syndrome; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Renal Insufficiency, Chronic; Safety; Smith-Magenis Syndrome; Warfarin