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The need to integrate songs into English Language Teaching (ELT) has been recognized on numerous occasions. Song lyrics host multi-word units which learners can reuse as building blocks in their English, thereby reducing language processing time and effort, and improving their fluency as well as idiomaticity, thus bringing them closer to the native speaker norm. We report on two studies into the effectiveness of using songs for teaching multi-word units to high-school Polish learners of English. The same items were taught to two groups of EFL learners, but only one of the groups heard them in a song. Learners’ vocabulary recall was measured at three points in time relative to the teaching: before, immediately after, and a week after. The group taught with songs showed a significant recall advantage over the other group, especially when tested a week from teaching. The results suggest that songs can be an effective vehicle for teaching English multi-word units. Keywords: song; English; vocabulary learning; multi-word units; formulaic language; positive psychology

ObjectiveThe severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) has caused a pandemic claiming more than 4 million lives worldwide. Overwhelming Coronavirus-Disease-2019 (COVID-19) respiratory failure placed tremendous demands on healthcare systems increasing the death toll. Cost-effective prognostic tools to characterize COVID-19 patients’ likely to progress to severe hypoxemic respiratory failure are still needed.DesignWe conducted a retrospective cohort study to develop a model utilizing demographic and clinical data collected in the first 12-hours admission to explore associations with severe hypoxemic respiratory failure in unvaccinated and hospitalized COVID-19 patients.SettingUniversity based healthcare system including 6 hospitals located in the Galveston, Brazoria and Harris counties of Texas.ParticipantsAdult patients diagnosed with COVID-19 and admitted to one of six hospitals between March 19th and June 31st, 2020.Primary outcomeThe primary outcome was defined as reaching a WHO ordinal scale between 6-9 at any time during admission, which corresponded to severe hypoxemic respiratory failure requiring high-flow oxygen supplementation or mechanical ventilation.ResultsWe included 329 participants in the model cohort and 62 (18.8%) met the primary outcome. Our multivariable regression model found that lactate dehydrogenase (OR 2.36), qSOFA score (OR: 2.26), and neutrophil to lymphocyte ratio (OR:1.15) were significant predictors of severe disease. The final model showed an area under curve (AUC) of 0.84. The sensitivity analysis and point of influence analysis did not reveal inconsistencies.ConclusionsOur study suggests that a combination of accessible demographic and clinical information collected on admission may predict the progression to severe COVID-19 among adult patients with mild and moderate disease. This model requires external validation prior to its use.STRENGTHS AND LIMITATIONS OF THIS STUDY⍰Our study utilized objective and measurable demographic and clinical information regularly available in healthcare settings even among patients unable to communicate.⍰Our primary outcome corresponds to WHO ordinal score which would allow compare our results to other studies and in other settings.⍰Our model could serve as an effective point of service tool during early admission to assist in clinical management and allocation of resources to unvaccinated patients.⍰Our study is a retrospective study of unvaccinated COVID19 patients, and validation of our prediction model in the rest of our study population is still needed.⍰In addition, testing our model in a more recent cohort after emergence of new SARS-CoV-2 variants will be needed to assess its robustness.

An effective visual perception strategy helps a fencer quickly react to an opponent’s actions. This study aimed to examine and compare visual perception strategies used by high-performance foil fencers (experts) and beginners. In an eye tracking experiment, we analysed to which areas beginning and expert fencers paid attention during duels. Novices paid attention to all examined areas of interest comprising the guard, foil (blade and tip), armed hand, lower torso, and upper torso of their opponents. Experts, however, paid significantly less attention to the foil, picking up information from other areas, mainly the upper torso and the armed hand. These results indicate that expert fencers indeed engage different visual perception strategies than beginners. The present findings highlight the fact that beginner fencers should be taught already in the early stages of their careers how to pick up information from various body areas of their opponents.

Psychoactive compounds that contain a phenylethylamine structure (such as amphetamine-type stimulants and synthetic cathinones) are one of the major classes of stimulants on the recreational drug market. Approximately 670 new psychoactive substances (NPS) are monitored only in Europe; however, new psychoactive compounds are being developed for illicit trade each year. In this context, the development of new analytical procedures for the determination of such compounds in biological specimens for forensic toxicology is of great importance. Gas chromatography–tandem mass spectrometry (GC–MS/MS) technique was applied for analysis of amphetamines and synthetic cathinones. The volumes of 200 µL of each whole blood sample and 1 mL of liquid-liquid extraction solvent were used for extraction, followed by pentafluoropropionyl derivatization. A high-throughput, robust, rapid, and sensitive procedure involving a simple liquid-liquid extraction for the simultaneous determination of 45 amphetamine-type stimulants and synthetic cathinones in whole blood was developed. The assay was validated based on its recovery (83.2–106%), interday accuracy (89.0–108%), and interday precision (≤ 8.1%). In view of the low limits of detection (ranged between 0.02 and 0.72 ng/mL) and limits of quantification (1 and 2.5 ng/mL), the developed method can serve as a less expensive and more ecologically friendly alternative to the liquid chromatography–tandem mass spectrometric methods. To the best of our knowledge, this is the first work presenting a GC–MS/MS method for the determination of NPS in blood samples. The presented procedure was applied to authentic samples from forensic cases, demonstrating its utility in the quantification of a wide number of psychoactive substances in routine toxicological analyses. The developed procedure can also be easily expanded to additional compounds.

The case of a 69-year-old man, equipped with an ICD and suffering from several chronic cardiac diseases, who died in a caraccident, was presented. We analyzed electrogram records from the ICD explanted from the body during the autopsy, which showed that thedriver had suffered from malignant ventricular arrhythmia—ventricular fibrillation (VF). A thorough analysis of the details of the accident, aswell as the timing of VF and the rhythm observed after the discharge of the ICD showed that the direct cause of the accident was the episodeof arrhythmia resulting in a loss of consciousness. Therefore, the presented case illustrates the usefulness of postmortem analysis of electrogramrecords from ICDs in the reconstruction of road traffic accidents. In such cases, if the victims are implanted with ICDs, it should be a routineprocedure performed by forensic pathologists.

Purpose The 4-chloromethcathinone (4-CMC) is a synthetic derivative of cathinone and belongs to new psychoactive substances. Neither data on the effects of 4-CMC on the human body, nor on nontoxic, toxic and lethal concentrations in biological materials have been published in the literature. This paper describes the results of an analysis of the blood concentrations of 4-CMC determined in 15 forensic cases related to nonfatal intoxication including driving under the influence, and fatalities including overdoses, suicide and traffic accidents. Methods A new method for the quantification of 4-CMC using gas chromatography–mass spectrometry (GC–MS) was developed. The symptoms of 4-CMC use were also studied based on an analysis of the documents prepared during the collection of samples or at autopsies. Results The limits of detection and quantification of the method for blood samples were 0.3 and 1 ng/mL, respectively. The calibration curve was linear in the studied concentration range (1–500 ng/mL) with the correlation coefficient at 0.9979. The extraction recoveries varied in the range of 94.3–98.8%. The accuracy and precision were acceptable. The determined concentrations in nonfatal cases ranged from 1.3 to 75.3 ng/mL, and in fatalities from 56.2 to 1870 ng/mL. Conclusions Our study can assist in the recognition of the possible effects caused by 4-CMC and can be helpful during the preparation of forensic toxicological opinions for courts of law. The validation parameters indicate the sensitivity and accuracy of the method. This is the first work presenting a validated method for the determination of 4-CMC in blood samples by GC–MS.

The study according to the title will constitute the presentation of conclusions from discussions on the potential impact of functioning of the Euroregion to the level of the digitization in regions they embrace. Euroregions are peripheral areas regarding to centres of the growth to which the new EU program Connecting Europe Facility is directed. This program has three elements: e-energy, e-transport and the e-digitization. The aim of the Strategy Europe 2020 is „bringing closer” the most distant regions to EU’s “hearts” and the Connecting Europe Facility serves this purpose, in particular the element of the digitization (including the broadband Internet). In the study Authors will make an attempt to find the answer to a question of what effects of using these instruments it is possible to expect in Euroregions spreading through Polish areas.

Recent years have witnessed revival of academic interest in the study of two areas. One is related to processing of emotional input, both linguistic and nonlinguistic; the other is centred on mechanisms underlying bilingual language comprehension and production. The current volume comprises substantial contributions by researchers working within various fields of linguistics and psychology. The Authors elaborate upon cognitively sophisticated frameworks for conceptualising the complexities of attitudes towards and beliefs about language, i.e. language regard (Preston 2010), and for explaining how affective processing interacts with linguistic performance (Sharwood Smith and Truscott 2014). Affective processing is further explored by Kissler and Strehlow (this volume), who offer a neurophysiological account of the interplay of emotionally charged language and non-linguistic behaviour. Further experimental evidence on language processing is provided by Cieślicka et al. (this volume), who investigate the effects of factors determining patterns in figurative language processing in bilinguals. Vital factors playing a role in bilingual language processing are also discussed at length in the final contribution to the volume (Jankowiak and Rataj, this volume), which, once again, takes a neurophysiological perspective. Together, the presented accounts offer complementary views on the intricacies of linguistic and affective processing and their interactions in monolingual and bilingual populations.

Left handers have long held the edge over right handers in one-on-one interactive combat sports. Particularly in fencing, top rankings show a relatively strong overrepresentation of left handers over right handers. Whether this can be attributed to perceptual strategies used by fencers in their bouts remains to be established. This study aims to verify whether right-handed fencers assess their opponents’ behaviour based on different perceptual strategies when fencing a left vs. right hander. Twelve top-level (i.e., Olympic fencers, Junior World Team Fencing Champions, and top Polish senior foil fencers) right-handed female foil fencers (aged 16–30 years) took part in the study. They performed a total of 40 actions: 10 repetitions of offensive actions (attack) and 10 repetitions of defensive actions (defence), each type of action performed under 2 conditions (right- vs. left-handed opponent). While the participants were fencing, their eye movements were being recorded with a remote eye-tracker (SMI ETG 2.0). Both in their offensive and defensive actions, the fencers produced more fixations to the armed hand and spent more time observing the armed hand in duels with a left-handed (vs. right-handed) opponent. In defence, it was also the guard that attracted more fixations and gained a longer observation time in bouts with a left hander. In duels with a right-handed opponent, a higher number of fixations in attack and in defence, and longer observation times in defence were found for the upper torso. The results may point to different perceptual strategies employed in bouts with left- vs. right-handed individuals. The findings from this study may help to promote the implementation of specialized perceptual training programmes in foil fencing.

An increase in cocaine consumption has been observed in Europe during the last decade. Benzoylecgonine, as a main urinary metabolite of cocaine in human, is so far the most reliable marker of cocaine consumption. Determination of cocaine and its metabolite in complex biological samples as urine or blood, requires efficient and selective sample pretreatment. In this preliminary study, the newly synthesized sorbent materials were proposed for selective extraction of cocaine and benzoylecgonine from urine samples. Application of these sorbent media allowed to determine cocaine and benzoylecgonine in urine samples at the concentration level of 100ng/ml with good recovery values as 81.7%±6.6 and 73.8%±4.2, respectively. The newly synthesized materials provided efficient, inexpensive and selective extraction of both cocaine and benzoylecgonine from urine samples, which can consequently lead to an increase of the sensitivity of the current available screening diagnostic tests.

This study sought to determine differences in fencers' visual perceptions during duels (preparatory actions) with right- versus left-handed opponents. Participants were 12 top-ranking right-handed female foil fencers (aged 16-30 years, M = 20.86, SD = 4.76) taking part in a training camp. Testing employed SensoMotoric Instruments Eye Tracking Glasses (SMI ETG 2.0) with eye-tracking analyses covering the visual attention time devoted to various areas of the opposing fencer's body (areas of interest), average fixation, number of glances, and number of fixations during preparatory actions in duels. Each test was conducted during preparatory actions in 20-second staged duels, first against a right-handed, and then against a left-handed opponent. Against left-handed (vs. right-handed) opponents, fencers spent significantly more time looking at and significantly more often fixated on the armed hand. When fighting against right-handed (vs. left-handed) opponents, fencers devoted more time and fixated more often on the opponent's upper torso. These results may point to an interesting phenomenon in which left-handed fencers benefit from weaker strategies adopted by their right-handed opponents who may fixate on the forearm and arm of the weapon hand.

Von Meyenburg complexes is one of the polycystic liver diseases, characterized by bile duct hamartoma. These cysts come from the biliary tract but the cysts do not communicate with them. Because of asymptomatic course of the lesions usually are diagnosed in the course of diagnostic for another reason. It is not possible to define the entire diagnosis based upon ultrasonography imaging, as cyst could mimic metastasis, micro-abscesses and multiple focal nodular lesions. Because of the small size of the lesion (0.5-15 mm) usually inconclusive is also computed tomography. On the basis of magnetic resonance imaging (MRI) and cholangio-MRI we can determine the diagnosis of the complexes. Liver biopsy is obligatory in case of suspicion of neoplastic process. These complexes do not require treatment, but long-term follow-up is indicated because of the possibility to more frequent cholangiocarcinoma in patient with von Meyenburg complexes. It is probably the first case report of the von Meyenburg complexes described in Poland.

We examine cross-linguistic influence in the processing of motion sentences by L2 users from an embodied cognition perspective. The experiment employs a priming paradigm to test two hypotheses based on previous action and motion research in cognitive psychology. The first hypothesis maintains that conceptual representations of motion are embodied by sensory and motor systems (Glenberg & Kaschak, 2002; Zwaan & Taylor, 2006) and predicts that linguistic descriptions of motion will be susceptible to conceptual priming effects. The second hypothesis assumes that the processing of fictive motion sentences, such as The road runs through the forest (cf. Talmy, 2000a), involves additional mental simulation of motion (Matlock, 2004b; Richardson & Matlock, 2007) and predicts that fictive motion will be processed more slowly than real motion. The participants were groups of Polish and English monolinguals and Polish L2 users of English, who were students in an English-medium university program. Sentence meaningfulness judgment and response time data were collected from the monolinguals and the L2 users tested in both languages. Sentence meaningfulness judgments were examined to see how the participants represent motion in language and response time data were analyzed for evidence of conceptual processing. The results showed expected differences in response times to various sentence types in all groups, but the priming effect was not observed in Polish monolinguals and only selectively present in the L2 users responding in both languages. The results of our experiment indicate that fictive motion processing is both embodied in physical experience of motion and modified by language. [ABSTRACT FROM AUTHOR]

Meeting of the convergence criteria adopted in the Maastricht Treaty allows to ensure the stability of the zone and to increase its position in the international arena. For this to happen, achieving of the required level of convergence must be long-term and based on sound evidence. Greece when it joined the Eurozone has much abused the trust of the European Union (EU) authorities when using false data it secured its place among the other holders of the Euro currency. The intention of the paper is to present basing on the example of Greece, the importance of compliance with the convergence criteria imposed by the European Union, and its purpose is to analyze the causes of the Greek crisis and its impact on the functioning of the Eurozone and the EU.

Streszczenie Opracowanie zostalo poświecone problematyce zarządzania gospodarczego strefą euro. Miedzynarodowy kryzys finansowy uwydatnil bowiem slabośc konstrukcji unii gospodarczej i walutowej. Niewykluczone jest, iz dalsze istnienie strefy bedzie zalezne od wypracowania przez kraje czlonkowskie optymalnych ściezek realizacji koniecznych reform. Celem opracowania jest prezentacja procesu ewolucji narzedzi zarządzania gospodarczego w strefie euro, w warunkach kryzysu. W ciągu ostatnich czterech lat panstwa czlonkowskie oraz struktury instytucjonalne Unii Europejskiej podjely szereg, czesto bezprecedensowych, dzialan mających na celu ratowanie gospodarek strefy euro. Przyczynilo sie to do zwiekszenia stopnia komplikacji zasad polityki fiskalnej i monetarnej. Co wiecej, nadal nie ma pewności, czy wypracowane instrumenty przeciwdzialania kryzysom bedą w stanie uchronic strefe euro od kolejnego zalamania . Slowa klucze: strefa euro, kryzys finansowy, zarządzanie gospodarcze ECONOMIC GOVERNANCE IN EURO ZONE IN CONDITIONS OF CRISIS Summary The study regards the issue of the euro zone’s economic governance. The international financial crisis highlighted the weakness of the construction of the economic and monetary union. It is conceivable that further existence of the euro zone will depend on whether the member states manage to find optimal ways to carry out necessary reforms. The aim of this paper is to present the evolution process of the tools used for the EU economic governance under the conditions of crisis. In the last four years, the Member States and institutional structures of the European Union have taken a number of, frequently unprecedented, actions aimed at saving the economies of the euro zone. This has contributed to increased complexity of the principles of fiscal and monetary policy. What is more, it is still not certain if the available instruments for crisis prevention will protect the euro zone from another economic meltdown.

The paper presents a unique case of a complex suicide committed by a young man, mostly probably triggered by a disappointment in love. The uniqueness of the suicide lies in the fact that the victim inflicted several deep stab wounds on himself, in the chest and abdomen, while standing partly submerged in the sea and, having done so, he dropped and disappeared in the water. The postmortem examination showed, apart from deep wounds in the trunk, characteristics of drowning that manifested itself in the form of aqueous emphysema of the lungs. Suicide was clearly determined on the basis of the circumstances preceding death, the location, and arrangement of the trunk wounds and the testimony given by a witness of the incident. The circumstances preceding the suicidal act clearly suggest an underlying undiagnosed mental disorder.

The prognosis for patients with mantle cell lymphoma (MCL) is poor, and at present there is no truly effective therapy. Gene translocation-mediated constitutive expression of cyclin D1 seems to play the key role in the pathogenesis of MCL. Here we report that although 3 of 4 MCL cell lines expressed the recently identified, highly oncogenic cyclin D1b isoform, as well as the canonical cyclin D1a, 8 MCL patient samples expressed only the cyclin D1a protein despite expressing detectable cyclin D1b mRNA. Cell lines and tissue samples displayed constitutive activation of the cyclin D1 signaling cascade, as evidenced by strong expression of CDK4, Rb phosphorylation, and cyclin D1/CDK4 coassociation. All MCL cell lines and tissues examined displayed nondetectable to diminished expression of the cyclin D1 inhibitor p16. Novel small molecule CDK4/CDK6 inhibitor PD0332991 profoundly suppressed—at low nanomolar concentrations—Rb phosphorylation, proliferation, and cell cycle progression at the G0/G1 phase of MCL cells. These findings provide evidence that MCL should be very sensitive to targeted therapy aimed at functional inhibition of the cyclin D1/CDK4 complex.

With this study we have demonstrated that in vitro transduction of normal human CD4(+) T lymphocytes with NPM-ALK results in their malignant transformation. The transformed cells become immortalized and display morphology and immunophenotype characteristic of patient-derived anaplastic large-cell lymphomas. These unique features, which are strictly dependent on NPM-ALK activity and expression, include perpetual cell growth, proliferation, and survival; activation of the key signal transduction pathways STAT3 and mTORC1; and expression of CD30 (the hallmark of anaplastic large-cell lymphoma) and of immunosuppressive cytokine IL-10 and cell-surface protein PD-L1/CD274. Implantation of NPM-ALK-transformed CD4(+) T lymphocytes into immunodeficient mice resulted in formation of tumors indistinguishable from patients' anaplastic large-cell lymphomas. Our findings demonstrate that the key aspects of human carcinogenesis closely recapitulating the features of the native tumors can be faithfully reproduced in vitro when an appropriate oncogene is used to transform its natural target cells; this in turn points to the fundamental role in malignant cell transformation of potent oncogenes expressed in the relevant target cells. Such transformed cells should permit study of the early stages of carcinogenesis, and in particular the initial oncogene-host cell interactions. This experimental design could also be useful for studies of the effects of early therapeutic intervention and likely also the mechanisms of malignant progression.

The paper proposes tests to assess psychomotor impairment in drivers suspected of using substances acting similarly to alcohol. The authors also present a proposal for the protocol to be used in sampling and testing of saliva, blood and urine when psychoactive substance abuse has been suspected. A detailed procedure is based on the joined experience of German, U.S. and Polish police from Gdansk. The purpose of the appendix is to help police officers to perform and document tests confirming psychomotor impairment, as well as to provide the basis for saliva, urine and blood analysis.

The study highlighted the problem of intoxication using substances and/or preparations, to which nowadays young people have unrestricted access. Based on the case developed in the Department of Forensic Medicine of the Medical University of Gdansk, our team members were able to gather information showing "ingenuity" of today's teenagers, which was reflected in the types of preparations used to induce a state of euphoria and intoxication. The study was based on the case of a 17-year-old woman, who took Acodin in combination with compressed air used to clean computer keyboards in order to induce psychoactive effects. The study used qualitative and quantitative methods: GC-FID and GC-MS. The results were compared with data from the literature.

Trisomy 8 is a common cytogenetic abnormality in myeloid malignancies. It can also be present constitutionally and is associated with a wide range of phenotypes. We report a case of a 20 year old woman with acute myelogenous leukemia (AML) associated with the 11q23/MLL translocation who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from a healthy, unrelated 26 year old female. Cytogenetics on a bone marrow biopsy and aspirate performed 71 days after transplant to evaluate pancytopenia identified trisomy 8 in 6 of 7 cells examined. The bone marrow was hypocellular but normal by morphology and flow cytometry. Fluorescent in situ hybridization (FISH) for the original 11q23/MLL translocation was negative. Chimerism analysis using multiplex polymerase chain reaction (PCR) to amplify an informative short tandem repeat (STR) demonstrated 97% donor cells. These findings were confirmed by repeat bone marrow biopsies at day 110 after transplant and one year after transplant. With resolution of co-morbid illness, the patient’s peripheral blood counts recovered and remained normal at one year after HSCT. FISH analysis of a cryopreserved sample of the donor graft showed trisomy 8 in 120 of 200 cells examined. This represents the first reported case of a person with constitutional trisomy 8 mosaicism serving as a stem cell donor. The case illustrates the importance of identifying donor derived constitutional abnormalities to avoid the assumption that these cytogenetic abnormalities after HSCT are representative of malignant disease.

All-trans-retinoic acid has dramatically changed the treatment paradigm for acute promyelocytic leukemia, however, it has no significant activity in non-M3 acute myeloid leukemia (AML). In vitro, bexarotene, a retinoid X receptor agonist inhibits the proliferation of non-M3 AML cell lines and induces differentiation of leukemic blasts from patients. We hypothesized that there may be similar activity in patients with AML. We report on two patients with relapsed or refractory non-M3 AML treated with bexarotene monotherapy. After initiating treatment, both patients showed leukemic differentiation in their peripheral blood and reduction in bone marrow blasts to less than 5%. One patient had a significant improvement in her platelet count with loss of platelet transfusion needs. Differentiation syndrome occurred in one patient and was successfully treated with steroids and discontinuation of bexarotene. These data suggest that bexarotene has clinical activity in non-M3 AML and may be able to induce myeloid differentiation in vivo.

Diffuse large B-cell lymphomas (DLBCLs) are a clinically and biologically heterogeneous group of hematologic malignancies. Specific genetic aberrations underlie some of this heterogeneity. These genetic events include distinct and separate translocations resulting in the dysregulated expression of either BCL6 protein with the t(3;14)(q27;q32) or c-MYC protein with the t(8;14)(q24;q32), as a consequence of the juxtaposition of these oncogenes with heterologous promoters or enhancers, such as those of the immunoglobulin heavy chain gene. Here, we report the case of a patient with DLBCL with a unique t(3;8)(q27;q24.1) that involves the BCL6 and MYC genes. We know of no previous report of this translocation in DLBCL, which simultaneously affects two key genes implicated in lymphomagenesis and may reflect a novel genetic mechanism in neoplastic transformation.

Background: Imatinib has become standard front-line therapy for CML. In ~3% of patients treated with imatinib, abnormalities including trisomy 8 and/or monosomy 7 occur in Ph’ negative subclones and dysplasia occasionally is present, but transformation to AML is rare. We describe the first known case of AML with an MLL translocation during an imatinib-induced molecular remission of CML. Methods: The Ph’ and the t(11;19)(q23;p13.1) were detected and monitored in sequential marrows using cytogenetic and FISH analyses. The BCR-ABL1 fusion transcript was traced by RT-PCR. The MLL translocation was identified and characterized in the AML blasts by Southern blot analysis, panhandle PCR-based methods and conventional PCR. Clinical History and Results: The patient presented with chronic phase CML at age 53 and was treated with hydroxyurea for 6 weeks, IFN-α for 20 months and imatinib for 32 months. Complete cytogenetic response was achieved at 10 months. Molecular remission, as indicated by absence of the BCR-ABL1 transcript, occurred after 15 months of imatinib (37 months from CML diagnosis). Mild dysgranulopoiesis was noted 6 months after imatinib was started and increased on subsequent studies. After 28 months of imatinib (50 months from CML diagnosis), there was marked trilineage dysplasia and the karyotype showed t(11;19)(q23;p13.1) in cells that were Ph’ negative and negative for the BCR-ABL1 fusion transcript. FAB M5b AML was diagnosed four months later. The patient succumbed to AML despite aggressive management with chemotherapy and allogeneic stem cell transplantation. Southern blot analysis of the AML revealed two MLL bcr rearrangements. The reciprocal breakpoint junctions on the der (11) and der (19) chromosomes indicated a translocation of intron 8 of MLL and intron 1 of the known MLL partner gene ELL, which encodes a transcription elongation factor. The involved region of MLL was more 5′ than the secondary leukemia translocation breakpoint hotspot. The der (11) fusion transcripts joined MLL exon 7 to ELL exon 2, which is consistent with alternative splicing, and the der (19) fusion transcript joined ELL exon 1 to MLL exon 9. Conclusions: Secondary leukemias with MLL translocations have been associated with topoisomerase II poisons, but not with the agents administered to this patient. The entity that we describe is distinct from blast crisis, in which Ph’ positive subclones evolve to acquire additional alterations. This case establishes that persistent clonal abnormalities and/or dysplasia in Ph’ negative cells following imatinib therapy may not be benign and may herald AML transformation. With effective and selective molecular eradication of the Ph’ positive clone, the emergence of leukemia with independent abnormalities may become more common. This is a highly concerning clinical complication to consider with BCR-ABL targeted agents.