BCR and chronic myelogenous leukemia, BCR-ABL1 positive: We describe a case of accelerated-phase CML involving three key molecular abnormalities: the insertion of a 154 bp SPECC1L exon 4 sequence into the e8a2 BCR::ABL1 fusion transcript, a concomitant ABL1 V379I mutation, and deletions near the t(9;22) breakpoint on derivative chromosome 9 (der(9)).