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We report on 10 <jats:italic>JAK2<\/jats:italic> V617F<jats:sup>pos<\/jats:sup>\/<jats:italic>BCR::ABL1<\/jats:italic>\n            <jats:sup>pos<\/jats:sup> patients in whom both mutations were identified simultaneously in 5\/10 (50%) patients or in whom <jats:italic>BCR::ABL1<\/jats:italic> appeared a median of 14 years after the primary diagnosis of <jats:italic>JAK2<\/jats:italic> V617F<jats:sup>pos<\/jats:sup> myeloproliferative neoplasia (MPN) in the remaining 5 patients. Granulocyte-macrophage colony-forming unit (CFU-GM) analysis demonstrated subsequent acquisition of <jats:italic>BCR::ABL1<\/jats:italic> in a pre-existing <jats:italic>JAK2<\/jats:italic> V617F<jats:sup>pos<\/jats:sup> clone in 8\/9 (89%) of evaluable patients. Despite the presence of <jats:italic>JAK2<\/jats:italic> V617F in all patients, atypical <jats:italic>BCR::ABL1<\/jats:italic> transcripts (e1a2\/e19a2) in 3\/9 (33%) patients and additional somatic mutations in 5\/9 (56%) patients, molecular remission of <jats:italic>BCR::ABL1<\/jats:italic> was achieved with different ABL1 TKIs (imatinib, <jats:italic>n<\/jats:italic>\u2009=\u20092, dasatinib, <jats:italic>n<\/jats:italic>\u2009=\u20092, nilotinib, <jats:italic>n<\/jats:italic>\u2009=\u20093) in 7\/9 (78%) patients. During a total of 217 months of treatment, concomitant treatment with ABL1 TKIs and ruxolitinib did not affect dosing, efficacy or side effects. We conclude that (i) a second driver mutation might occur in chronic phase MPNs, (ii) clonality analyses largely support a common disease origin, and (iii) the dose, efficacy and safety of ABL1 inhibitors and ruxolitinib are not mutually affected by concurrent treatment.<\/jats:p>","DOI":"10.1038\/s41598-025-11096-6","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T04:13:01Z","timestamp":1752811981000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical, morphological and genetic characteristics of patients with concurrent presence of JAK2 V617F and BCR::ABL1"],"prefix":"10.1038","volume":"15","author":[{"given":"Nicole","family":"Naumann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Dangelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"L\u00fcbke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Bresser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Hagen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Dengler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Metzgeroth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Kreil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabea","family":"Hockenberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf-Karsten","family":"Hofmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Fabarius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Saussele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas C. 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