In the present study, a novel case of a Ph chromosome-positive CML in BC was identified, with a four-way rearrangement involving five chromosomal regions, 9p21, 9q34, 12p13.3, 20q11.2 and 22q11.2, an unbalanced translocation der(7)t(7;8) (p11.2;q11.2), deletions of ABL and argininosuccinate synthetase (ASS) genes at 9q34 on der(9), partial monosomies 8, 12 and an additional Ph chromosome. Here, ASS1 is linked to chronic myelogenous leukemia, BCR-ABL1 positive.