There are rare reports of pulmonary toxicity with nilotinib and it is also possible that this is a complication of the patient’s allogeneic stem cell transplant. Known late complications include, idiopathic pneumonia syndrome (IPS), bronchiolitis obliterans syndrome (BOS), and cryptogenic organizing pneumonia (COP). Since his PCR has been undetectable for nine years, one possibility would be to discontinue nilotinib with close observation of his PCR for BCR-ABL and the pulmonary process. It would also be possible to switch to bosutinib, but with close monitoring for recurrence of pulmonary hypertension, if the patient or physician do not want to risk relapse.