Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 19 3 2025 07 21 291 295 Vishnu Sharma Department of General Medicine, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India Sidharth Mahajan Government Medical College, Amritsar, India Vansh Bagrodia Department of General Medicine, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India Jahanvi Grover PGIMS, Rohtak, India Vaibhav Oberoi Government Medical College, Amritsar, India 2024 03 03 2024 05 29 This case study outlines the complex treatment journey of a 53-year-old male diagnosed with Chronic Myeloid Leukemia (CML). Despite initial therapy with Imatinib and a subsequent switch to Dasatinib and then Bosutinib due to treatment resistance and adverse effects, the patient experienced multiple unexpected complications, including bilateral pleural effusions, pulmonary arterial hypertension, renal impairment, and neurological symptoms. Bosutinib was identified as the likely cause, leading to its discontinuation and transition to Nilotinib, which resulted in a sustained molecular response without further adverse events. Through this case report and literature review, we aim to expand the dimensions of the toxicity profile of bosutinib.                                                           https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/2187 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/2187/1094