3 a-Inclusion criteria  1_clinical diagnosis of Philadelphia positive leukemic patients (males and females).  2- Aged from 18- 60 years. 3-All eligible patients presenting at Clinical Haematology Unit Internal Medicine Department.  4- Without contraindication to receive TKIs therapy. 5-Must able to swallow tablet(TKI therapy).  -exclusion criteria  NO bone marrow aspirate and flow cytometry confirm their diagnosis. patients who refuse to participate in the study.