**5. Chronic myeloid (***Myelogenous***) leukemia (CML)**

Chronic *Myelogenous* Leukemia (CML) is a clonal myeloproliferative disorder characterized by the increased and unregulated growth of *myeloid* cells due to translocation between long arms of chromosomes 9 and 22t (9;22) that generates tyrosine kinase BCR-ABL1 [34]. CML classified into 3 phases; chronic stable phase (CP) which the myeloid cell series is expanded but cellular differentiation is maintained and effortlessly controlled with treatment for a period that can last for 36–60 months but the accelerated phase (AP) can lasts for less than 12 months. Blast phase (BP) are still poorly understood, characterized by rapid expansion of myeloid or lymphoid with presence of more than 20% blast cells in the peripheral blood or bone marrow resulting in manifestation of ALL or AML and death in short period within 4–6 months [35].

Chronic myeloid (*Myelogenous)* leukemia treatment progressed significantly through the advancement of tyrosine kinase inhibitors (TKIs), particularly the presentation of imatinib into the clinical use. Imatinib is the drug of choice of the first generation in the chronic phase of CML and considered the golden standard target therapy in CML. The second generations also currently available for clinical use include nilotinib, dasatinib, bosutinib and ponatinib.

To maintain patients in remission and prevent progression of disease into accelerated and blast phases are the main treatment goals of chronic myeloid leukemias and keep the patients free of complications and with minimal drug related toxicity.

Target therapy with TKIs and allogenic bone marrow transplantation, play important role in improvement curative percentage of CML patients.
