{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:16:51Z","timestamp":1790983011021,"version":"4.1.0"},"reference-count":5,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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":["Respirology Case Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Therapy\u2010related chronic myeloid leukaemia (t\u2010CML) is an extremely rare myeloid neoplasm. Here, we report a first case of CML developing during long\u2010term treatment with alectinib, a highly selective tyrosine kinase inhibitor (TKI) targeting anaplastic lymphoma kinase (ALK). A 53\u2010year\u2010old never\u2010smoking woman with\n                    <jats:italic>ALK<\/jats:italic>\n                    \u2010positive non\u2010small cell lung cancer (NSCLC) developed mediastinal lymph node and brain metastases after curative surgery. Alectinib therapy achieved sustained systemic and intracranial disease control for nearly 3\u2009years without serious adverse events. However, 3\u2009years and 1\u2009month after initiating alectinib, progressive leukocytosis with marked basophilia and circulating immature myeloid cells was observed. Bone marrow analysis confirmed the diagnosis of CML with\n                    <jats:italic>BCR\u2010ABL1<\/jats:italic>\n                    fusion. Nilotinib was initiated while alectinib was continued, resulting in a rapid hematologic response without serious adverse events. Further accumulation of cases is needed to clarify the potential leukemogenic risk of ALK\u2010TKIs and to establish the safety and clinical utility of combined ALK\u2010TKI and BCR\u2010ABL\u2010TKI therapy.\n                  <\/jats:p>","DOI":"10.1002\/rcr2.70717","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:11:23Z","timestamp":1786950683000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Chronic Myeloid Leukaemia Developing During Long\u2010Term Alectinib Therapy Successfully Managed With Concomitant Nilotinib: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3006-4489","authenticated-orcid":false,"given":"Yuki","family":"Ikematsu","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Graduate School of Medical Sciences Kyushu University  Fukuoka Japan"},{"name":"Department of Respiratory Medicine National Hospital Organization Omuta National Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2624-0339","authenticated-orcid":false,"given":"Miiru","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine National Hospital Organization Omuta National Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9285-880X","authenticated-orcid":false,"given":"Kentaro","family":"Wakamatsu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine National Hospital Organization Omuta National Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine National Hospital Organization Omuta National Hospital  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V96.10.3343"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428199809058378"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704795"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e37040"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912614"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70717","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/rcr2.70717","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70717","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:22:37Z","timestamp":1787800957000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.70717"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":5,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/rcr2.70717"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.70717","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-05-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70717"}}