Management of Bcr-Abl-positive leukemias with dasatinib

Dasatinib is a novel, potent, multi-targeted kinase inhibitor that is approved in Philadelphia chromosome positive (Ph+) chronic myelogenous leukemia (CML) and Ph+ acute lymphoblastic leukemia following imatinib failure. Clinical trials have demonstrated its activity across all phases of CML. Dasatinib was superior to high-dose imatinib in a randomized, Phase II study of patients with chronic-phase CML who were resistant or intolerant to imatinib. Preliminary data from a Phase II trial in patients with previously untreated CML suggests that dasatinib compares favorably with imatinib in first-line use. Adverse events experienced with dasatinib include myelosuppression and fluid retention (e.g., pleural effusions), which were manageable with dose adjustment or treatment.