{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T19:02:54Z","timestamp":1783191774837,"version":"3.54.6"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Chronic myeloid leukemia (CML) in chronic phase (CP) typically follows an indolent course. We report a highly aggressive pediatric case with a discordant presentation. A 10\u2010year\u2010old girl presented with rapidly progressive symptoms and hyperleukocytosis (WBC 448.7\u00a0\u00d7\u00a010\n                    <jats:sup>9<\/jats:sup>\n                    \/L). Initial bone marrow examination was morphologically diagnostic for CML\u2010CP (blasts 1%). Conventional cytogenetics revealed a complex three\u2010way translocation, t(7;9;22)(q11.23;q34;q11.2). Despite immediate initiation of a second\u2010generation tyrosine kinase inhibitor (TKI), the disease transformed to myeloid blast crisis (BC) within 1 month. This case demonstrates that complex variant translocations, in the absence of other risk factors by standard evaluation, may identify a subset of CML with exceptionally rapid kinetics and inherent TKI resistance. It underscores the high\u2010risk nature of certain cytogenetic findings, even with classic CP morphology, and highlights the critical prognostic information contained in a basic karyotype.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration<\/jats:bold>\n                    : The authors have confirmed clinical trial registration is not needed for this submission.\n                  <\/jats:p>","DOI":"10.1002\/jha2.70293","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:19:21Z","timestamp":1776428361000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Rapid Transformation to Myeloid Blast Crisis in a Pediatric CML Patient Harboring a Complex t(7;9;22)(q11.23;q34;q11.2) Variant Translocation: A Case Report"],"prefix":"10.1002","volume":"7","author":[{"given":"Ahmed Maseh","family":"Haidary","sequence":"first","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5027-5585","authenticated-orcid":false,"given":"Sarah","family":"Noor","sequence":"additional","affiliation":[{"name":"Department of Oncology Ali Abad Hospital Kabul University of Medical Sciences  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrin","family":"Hussaini","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna","family":"Amarkhail","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inamullah","family":"Muhib","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmatullah","family":"Esmat","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haider Ali","family":"Malakzai","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmadullah","family":"Hakimi","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mujtaba","family":"Haidari","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Sami","family":"Ibrahimkhil","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Saadaat","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratory French Medical Institute for Mothers and Children  Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"issue":"1","key":"e_1_2_15_2_1","first-page":"141","article-title":"Chronic Myeloid Leukemia: 2024 Update on Diagnosis, Therapy, and Monitoring","volume":"99","author":"Jabbour E.","year":"2024","journal-title":"American Journal of 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