**1. Introduction**

Chronic myeloid leukemia (CML) is a neoplasm characterized by clonal expansion of hematopoietic stem cells, resulting in increase of peripheral blood myeloid, erythroid, and platelet cells, with bone marrow (BM) myeloid hyperplasia [1, 2]. Typical symptoms of CML include fatigue, anorexia, and weight loss. However, about 40% of patients are asymptomatic, and in these patients the diagnosis is based on an abnormal blood count [1].

CML is categorized into three phases: chronic, accelerated, and blast crisis. At the beginning of the chronic phase (CP), some patients are asymptomatic, but others have fatigue, weakness, headaches, irritability, fever, night sweats, and weight loss. The accelerated phase (AP) comes after a variable period of diagnosis from a few months to several years, and it is characterized by increased bone marrow and peripheral blood blasts, peripheral blood leukocytosis and basophilia, anemia and thrombocytopenia unrelated to treatment, or the development of cytogenetic evolution. Subsequently, the disease progresses to the blast phase (BP), defined hematologically by the increase of leukemic blasts in the peripheral blood and/or bone marrow (more than 20%). At this stage of the disease, many patients die within 3–6 months. The progression to AP and BP seems to be associated mainly with genomic instability, which predisposes to the appearance of other molecular abnormalities [3].

The average diagnosis of CML is 64 years. However, all age groups, including children, are affected. About 15% of all leukemias are CML. It is estimated for the USA that 1 out of 526 people will have CML in their lifetime. The American Cancer Society estimates for CML in the USA by 2019: about 8990 new cases will be diagnosed with CML (5250 in men and 3740 in women) and about 1140 CML deaths (660 men and 480 women) [4].
