LAUSR

to receive Ibrutinib are elderly and are likely to require anticoagulant or antiplatelet therapy owing to associated comorbidities, including atrial fibrillation and ischemic diseases. Besides, due to the multiple interactions of Ibrutinib with several TKs beyond BTK, such as PI3K/AKT and ErbB2/HER2 [3, 4] involved in cardiovascular homeostasis, an increased incidence of cardiovascular events has been reported during drug administration. Directly acting oral anticoagulants (DOACs) represent a class of medications that inhibits a specific factor of the coagulation cascade. In comparison with warfarin, DOACs have a relatively short half-life and rapid action. In comparison with warfarin, they possess a more predictable and stable anticoagulation, making the requirement of laboratory monitoring and dose adjustments not necessary. The anticoagulant effect of DOACs and warfarin is equivalent, yet DOACs are less influenced by diet and medications and are associated with a definitely lower risk of major and fatal bleeding, of particular interest is the reduction in the risk of intracranial bleeding [5]. Although caution is advised for subjects requiring anticoagulants when treated with Ibrutinib, DOACs could be proposed as an alternative anticoagulant medication in CLL patients.