Objective: To investigate the dynamic change of absolute natural killer cell counts(ANKC) and its prognostic value for the treatment response in the newly diagnosed patients with chronic myeloid leukemia(CML) before and after 3 months and 12 months of tyrosine kinase inhibitors(TKI) treatment. Methods:All 80 patients with chronic-phase CML(CML-CP) diagnosed from 2014 to 2019 were treated with first-generation TKI(imatinib) or second-generation TKI(nilotinib, dasatinib). According to the treatment response,they were divided into two groups:the optimal response group and the warning/treatment failure group,aiming to analyze the influence of ANKC and related clinical data on prognosis. The receiver operating characteristic(ROC)curve was used to optimize the cut-off values of clinical indicator. Results:After 3 months and 12 months of treatment,the efficacy of patients with ANKC≥0.14×109 /L at the first diagnosis was better than those with lower ANKC(P < 0.05). Following 3 months of TKI treatment,ANKC in patients with optimal response was significantly lower than that at initial diagnosis(P < 0.001),whereas ANKC in patients without optimal response was significantly higher(P=0.017). Dynamic analysis was performed on the correlation between the changes in ANKC and the efficacy in 13 patients receiving dasatinib,and we found that in the patients with optimal response,ANKC after 3 months of treatment was significantly lower than that at the initial diagnosis(P=0.025),whereas ANKC after 12 months of treatment was significantly higher than that at the initial diagnosis(P=0.015). Multivariate analysis showed that ANKC,white blood cells count and second-generation TKI were independent factors for treatment response(P < 0.05). Conclusion:ANKC in CML-CP patients is an effective prognostic factor for TKI treatment response,meanwhile patients with ANKC≥0.14×109/L at diagnosis can achieve an optimal response.