Cytogenetic analysis of bone marrow cells of a 63-year-old male Caucasian patient with polycythemia vera [PV) who developed anemia, thrombocytopenia, and increased granulocytic imma turity revealed a 47,X,der(Y) t(Y;l)(ql2;ql2),+9 karyotype. The breakpoint in chromosome 1 appeared to map to ql2 and not to q21, as has been described in previous reports without FISH confirmation. In the 4 years before this transition the patient was polycythemic and, accordingly; treated with phlebot omy and three short courses of busulfan, The cytogenetic picture observed has been described before in seven patients: three with PV, three with myelodysplasia, and one with Fan coni anemia. In 5/7 cases, like in our patient, the abnormality was observed during transition of the disease into either myelodys plasia or AML.