A 62-year-old man presents with progressive fatigue, night sweats, and massive splenomegaly. Peripheral blood smear shows mature lymphocytes with smudge cells. Flow cytometry confirms CD5+CD19+CD23+ kappa-restricted B-cell clone (Matutes score 5). FISH panel reveals the abnormality marked **A** in the diagram. Which of the following is the MOST appropriate first-line therapeutic approach for this patient?
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