chronic myeloid leukemia ( cml ) is a chronic myeloproliferative disorder resulting due to translocation between chromosome 9 and 22 producing bcr - abl chimeric protein , which is a potent tyrosine kinase . this tyrosine kinase leads to cascade to signaling pathways causing malignant transformation of granulocytes and their resistance to apoptosis . the discovery of this genetic abnormality led to development of miracle drug of the decade we retrospectively analyzed cml patients in last 9 years from their case summaries and records . these patients underwent complete blood count ( cbc ) , pbf , leukocyte alkaline phosphatase score , bm exam , bcr - abl reverse transcription polymerase chain reaction at diagnosis followed by cbc monthly and bcr - abl every 6 month to assess the response . age ranged from 8 to 75 years main presentation in these patients was splenomegaly , fever , wt loss , and leukocytosis . 304 patients were new and 83 had received some form of treatment for more than 3 months . hematological response was seen in 368 patients with complete hematological response ( chr ) in 345 patients , partial hematological response in  37 patients and no response in 5 patients . sustained hematological response was observed in 305 patients while remaining patients could not maintain it due to poor compliance and loss of effect was seen with progression to blastic phase . a total of 305 patients were taking 400 mg imatinib to maintain chr while 67 were switched to 600 mg dose , 3 were taking 800 mg and rest were shifted back to hydroxyurea . the main side - effects observed were - facial puffiness , body ache , nausea and asthenia , hypo pigmentation initially with patchy hyper pigmentation later on , anemia and thrombocytopenia . a total of 89 patients had to discontinue the imatinib , out of which 33 patients had progression to blast crisis , 23 patients had persistent pancytopenia , 34 patients were lost to follow up due to social reason like not able to come to site etc . complete molecular response at 1 year was seen in 197 patients , major molecular response in 100 patients , no response in 17 patients and rest could not be assessed due to either progression or cost constraints . imatinib mutation analysis was performed in 5 patients of ap , but did not show any abnormality . all the 3 female patients were conceived and gave birth to total 5 babies , which do not have any congenital anomaly . imatinib has improved the quality - of - life and outcome of patients with cml . in our patient population chr water retention manifesting as edema , facial puffiness and hematological toxicity were main side - effects seen with imatinib . around 22% patients had to discontinue the drug leading to progression of disease in 37% ( 33/89 ) patients . this is a matter of concern as the outcome of such patients is quite poor and need proper follow - up and strategy to minimize the problem . another important observation seen in our study that female getting pregnant while on imatinib gave birth to normal babies contrary to reported cases where complex congenital abnormalities have been seen .
searoc cancer center presented the data 387 patients from the city of jaipur . 
 this oncology center caters large number of population from jaipur as well as from neighboring states . out of the 387 patients , 334 ( 86% ) 
 patients were in chronic phase . 
 complete hematological response was seen in 368 ( 95% ) of patients and no response in 5 patients . among these patients , 
 33 ( 8.5% ) progressed to blast crisis .