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The efficacy and safety of anti-tumor necrosis factor-alpha drugs have been shown in active ankylosing spondylitis cases that are resistant to traditional disease-modifying antirheumatic drugs. However, it is well known that these drugs may cause some complications as reactivation of tuberculosis and various hematologic malignancies. In this article, we report a 40-year-old male patient with ankylosing spondylitis who developed Philadelphia chromosome-positive acute lymphoid leukemia after treatment with tumor necrosis factor-alpha inhibitors. [ABSTRACT FROM AUTHOR]