Drugs for CML are now available in Pakistan including the latest FDA-approved drugs. CML or chronic myelogenous leukemia is a cancer of the white blood cells originating from the bone marrow.

Most cases of CML patients have a mutation in the Bcr-Abl resulting in the formation of the Philadelphia chromosome. Because the Philadelphia chromosome is the key pathologic change in patients with CML, most latest FDA-approved drugs target this chromosome.

All guidelines recommend the use of Tyrosine kinase inhibitors (TKIs) for the treatment of CML in the chronic phase. Most guidelines recommend the use of 2nd generation TKIs such as Bosutinib and nilotinib as a first line of treatment.

In addition, for patients who are Ph-positive and have the T315I gene mutation, Ponatinib or Asciminib are the preferred treatments.

TKIs (Tyrosine kinase inhibitors) are classified as:

Here is a list of all the TKIs (Tyrosine kinase Inhibitors) use to treat CML:

Most of the TKIs (Tyrosine kinase inhibitors) are now available in Pakistan except for the very latest ones. However, the DRAP has probably approved only a few.

Because some of the latest TKIs are not readily available, their prices may vary.

Here is a list of all the drugs including TKIs, and cytotoxic drugs that are available in Pakistan.

The treatment of CML has markedly changed over the last few years. It is one of the cancers with very high cure rates. This has become possible only after the introduction of the latest Tyrosine kinase inhibitors.

Response in CML is categorized either as:

• Clinical or hematologic response
• Cytogenetic response, and 
• Molecular response