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Chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML) are the most common leukemias of the elderly. However, the sequential occurrence of CML followed by CLL in the same patient is extremely rare. In the present report, a 71-yr-old man was diagnosed with Philadelphia (Ph) chromosome positive CML and treated with imatinib mesylate. He went into morphologic, cytogenetic, and molecular remission. Seven years after the diagnosis of CML, he developed CLL. We describe the morphologic, immunophenotypic, cytogenetic, and molecular findings in this patient.