The clinical importance of chronic alectinib-induced hemolysis appears to be limited in the short-term, as the percentage of patients with alectinib-induced grade 3–4 anemia is low, 5% in the ALEX study [5], and no association with PFS or prognostically relevant features, such as the EML4-ALK V3 and TP53 status, was noted in our patients [27,28]. Here, EML4 is linked to anemia.