{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:00:32Z","timestamp":1790146832242,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":264,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Case Reports in Hematology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    The concurrent occurrence of\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    rearrangement and\n                    <jats:italic>JAK2<\/jats:italic>\n                    V617F mutation is an exceptionally rare phenomenon, with reported frequencies of 0.2%\u20132.5% in tested myeloproliferative neoplasm (MPN) cohorts and an estimated overall rate of approximately 0.4% in patients screened for both alterations. These molecular drivers are generally considered mutually exclusive, as\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    defines Philadelphia chromosome\u2010positive (Ph+) chronic myeloid leukemia (CML), while\n                    <jats:italic>JAK2<\/jats:italic>\n                    V617F characterizes Ph\u2010negative MPNs. We report a male patient in his 50s with a previously detected\n                    <jats:italic>JAK2<\/jats:italic>\n                    V617F mutation, initially managed as essential thrombocythemia, who later presented with leukocytosis, macrocytic anemia, thrombocytopenia, and absolute monocytosis. Bone marrow demonstrated marked myeloid hyperplasia with atypical megakaryocytes, comprising scattered dwarf forms together with larger forms with \u201ccloud\u2010like\u201d nuclei and focal reticulin fibrosis (MF\u20101). These findings, together with the known\n                    <jats:italic>JAK2<\/jats:italic>\n                    V617F mutation, prompted targeted molecular investigation. High\u2010sensitivity RT\u2010PCR confirmed an isolated e1a2 (p190)\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    transcript, the minor breakpoint cluster region isoform occurring in only 1%\u20102% of CML cases, with the complete absence of the p210 isoform, alongside a concurrent\n                    <jats:italic>JAK2<\/jats:italic>\n                    V617F mutation (allele burden 16%). Standard p210\u2010focused quantitative assays would have produced a false\u2010negative result in this case. The patient received first\u2010line asciminib and was subsequently transitioned to dasatinib, with the\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    \/\n                    <jats:italic>ABL1<\/jats:italic>\n                    ratio declining from 88.5% at diagnosis to 0.79% at most recent assessment. This case highlights the critical importance of integrated morphologic, cytogenetic, and molecular evaluation in atypical MPN presentations. The admixed megakaryocytic atypia superimposed on myeloid hyperplasia reflected the coexistence of two drivers. Comprehensive profiling, including high\u2010sensitivity RT\u2010PCR capable of detecting the p190 isoform and concurrent\n                    <jats:italic>JAK2<\/jats:italic>\n                    testing, is essential for accurate diagnosis, prognostication, and therapy selection in these rare dual\u2010driver cases.\n                  <\/jats:p>","DOI":"10.1155\/crh\/2927231","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:09:01Z","timestamp":1790143741000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual\u2010Driver Myeloproliferative Neoplasm: Concurrent p190\n                    <i>BCR::ABL1<\/i>\n                    CML and\n                    <i>JAK2<\/i>\n                    V617F Mutation: A Case Report and Literature Review"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9327-8471","authenticated-orcid":false,"given":"Mohamed","family":"Elkady","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3581-0866","authenticated-orcid":false,"given":"Yulan","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6560-2780","authenticated-orcid":false,"given":"Weiqiang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01613-1"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015850"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2017.182"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-02-204693"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2017.62"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21165776"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-07-234666"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1329298"},{"key":"e_1_2_13_9_2","doi-asserted-by":"crossref","first-page":"62","DOI":"10.5045\/br.2020.55.1.62","article-title":"Clinical Significance of Myeloproliferative Neoplasms with JAK2 V617F Mutations and Major BCR-ABL1 Translocations: a Literature Review with Case Presentation","volume":"55","author":"Kim S. Y.","year":"2020","journal-title":"Blood Research"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.23838\/pfm.2019.00023"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2017.178988"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2013-0018-oa"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.14086"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpccr.2022.100151"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2024024776"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol32020097"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.12659\/ajcr.904956"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-04-148791"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa051113"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2024-200428"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-024-02353-0"},{"key":"e_1_2_13_22_2","doi-asserted-by":"crossref","DOI":"10.4084\/MJHID.2025.023","article-title":"Co-Occurrence of Jak2-Positive Myelofibrosis and bcr-abl-positive Chronic Myelogenous Leukaemia Treated with Combination of Tyrosine Kinase Inhibitors and Ruxolitinib","volume":"17","author":"Paciaroni K.","year":"2025","journal-title":"Mediterranean Journal of Hematology and Infectious Diseases"},{"key":"e_1_2_13_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/2324709619832322"},{"key":"e_1_2_13_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2009.08.009"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/10245332.2018.1498182"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-01082-4"},{"key":"e_1_2_13_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13932"},{"key":"e_1_2_13_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-026-02928-z"}],"container-title":["Case Reports in Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crh\/2927231","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crh\/2927231","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crh\/2927231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:09:07Z","timestamp":1790143747000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crh\/2927231"}},"subtitle":[],"editor":[{"given":"Kalyani","family":"Sen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crh\/2927231"],"URL":"https:\/\/doi.org\/10.1155\/crh\/2927231","archive":["Portico"],"relation":{},"ISSN":["2090-6560","2090-6579"],"issn-type":[{"value":"2090-6560","type":"print"},{"value":"2090-6579","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-06-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"2927231"}}