Background:-The hallmark diagnostic tool for Chronic myeloid leukemia (CML) is Philadelphiarnchromosome t (9; 22) (q34; q11)) which gives rise to bcr-abl1 fusion oncogenic protein. QrtPCRrnrnof bcr-abl1has been established as a prognostic tool since the introduction of TKI drugs.rnBut, in a resource-limited setting, like Ethiopia, multiplex reverse transcriptase PCR, which isrnused to be as a screening tool, could be adopted into the clinic as a relative prognostic tool thanrnrelying on hematological response. rnObjective: - to evaluate multiplex polymerase chain reaction (PCR) as prognostic tools forrnchronic myeloid leukemia (CML) patients in resource-limited settings at Tikur AnbessarnSpecialized Hospital (TASH).rnMethod: - Hospital-based Cross-sectional study design was used for a total of 114 confirmedrnCML patients who were enrolled at the Hematology Clinic of TASH. Multiplex reverserntranscriptase-polymerase chain reaction (RT-PCR) and quantitative reverse transcriptase PCRrnwere performed at AHRI molecular lab, and Leipzig hematology clinic, respectively. Therndescriptive statistic and ROC curve using excel were used to assess the demographic feature ofrnthe patients and to evaluate the prognostic value, respectively, and thereby the most valuable cutoffrnmultiplexrnPCRrnwasrncalculatedrnin comparisonrnwith QRT-rnPCR.rnrnrnResult:rnrn- of the total enrolled study subjects (114), most of the transcripts were major fusionrngene (M-bcr-abl1), b2a2 (28.1%), b3a2 (49.1%), and co-expressed were b2a2/b3a2 (0.9%). Allrnnew cases and follow-up patients who were positive with the multiplex RT-PCR method for bcrablrnrntranscript were more than 95% agreement with quantitative PCR compared to the limit ofrndetection sated for multiplex PCR. Multiplex RT- PCR at a cut-off 0.31% IS and above, inrncomparison to the standard prognostic tools (Qrt PCR) has a comparable result; sensitivity 96.6%rnand specificity 88% at the area under the curve 0.977(97.7 %) and CI 95% (0.952 to 1, P-valuern0.0001). rnConclusion: - Follow-up of patients on the hematological parameter is rather crude and notrnsensitive enough to modify the treatment regimen. But, the use of multiplex PCR, besides asrnscreening tools, can provide an early sign of relapse as low as 0.31% IS bcr-abl transcript. Asrncompared to Qrt-PCR, it is relatively cheap and accessible to be adopted into the routine clinic.