{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T04:19:26Z","timestamp":1761279566529,"version":"build-2065373602"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>\n                    In chronic myeloid leukemia (CML), less than 2% of cases express atypical or rare\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    transcripts. The e8a2\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    fusion transcript, a rare variant, has been reported in only 20 cases to date, primarily in case reports or case series. The direct junction between\n                    <jats:italic>BCR<\/jats:italic>\n                    exon 8 and\n                    <jats:italic>ABL1<\/jats:italic>\n                    exon 2 generates a premature stop codon at position 7 after the fusion, while the insertion of certain sequences can result in the formation of an in-frame e8a2 transcript. To date, the insertion of\n                    <jats:italic>SPECC1L<\/jats:italic>\n                    gene sequences into e8a2\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    fusion transcripts has been reported in two CML cases, and the V379I mutation (in\n                    <jats:italic>ABL1<\/jats:italic>\n                    ) has been identified in two additional CML cases. We describe a case of accelerated-phase CML involving three key molecular abnormalities: the insertion of a 154 bp\n                    <jats:italic>SPECC1L<\/jats:italic>\n                    exon 4 sequence into the e8a2\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    fusion transcript, a concomitant\n                    <jats:italic>ABL1<\/jats:italic>\n                    V379I mutation, and deletions near the t(9;22) breakpoint on derivative chromosome 9 (der(9)). The patient\u2019s clinical manifestations, cytogenetic features, and molecular genetic characteristics were summarized and discussed. Despite sequential therapy with full-dose dasatinib for 10 months and the third-generation tyrosine-kinase inhibitor (TKI) olverembatinib for 7 months, the patient experienced progressive disease. She ultimately achieved Major Molecular Response (MMR) after haploidentical hematopoietic stem-cell transplantation (haplo-HSCT). This case highlights the importance of comprehensive molecular profiling at diagnosis and the need to develop alternative therapeutic strategies for rare\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    variants.\n                  <\/jats:p>","DOI":"10.3389\/fonc.2025.1711888","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T04:14:35Z","timestamp":1761279275000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Dual resistance to dasatinib\/olverembatinib in accelerated-phase cml: identification of a novel SPECC1L-inserted e8a2 BCR::ABL1 transcript and ABL1 V379I mutation"],"prefix":"10.3389","volume":"15","author":[{"given":"Jingjing","family":"Fu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangming","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xueqin","family":"Ruan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Runfa","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanli","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhihong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haiqin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Lan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongrui","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27443","article-title":"Chronic 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