Study of Dasatinib in Patients With Chronic Myelogenous Leukemia

Dasatinib is an anticancer drug that is designed to block the function of BCR-ABL, which is
the abnormal protein responsible for causing leukemia in certain cells.

If you are found to be eligible to take part in this study and you agree, you will take
dasatinib once every day while on study. Dasatinib should be taken by mouth with water.

Every 1-2 weeks during the first 4 weeks of the study, you will have around 2 tablespoons of
blood drawn for routine blood tests. The blood tests will be repeated every 4-6 weeks until 1
year from when you started therapy and then every 3-4 months until 2 years, then as often as
the doctor thinks it is needed. A bone marrow aspiration will also be taken to check the
status of the disease every 3-4 months for the first year and then as often as the doctor
thinks it is needed for as long as you are on the study.

You will be given a medication diary to monitor any missed doses. You will also be asked to
visit the doctor for a physical exam and to have vital signs measured periodically. These
visits will be scheduled at least every 3-4 months for the first year, then recommended every
6 to 12 months while you are on the study. The visits may be scheduled more often depending
on the status of the disease.

Treatment may be continued for up to 15-18 years or as long as the doctor feels it is
necessary to control the leukemia. If the disease gets worse or you experience any
intolerable side effects, you will be taken off the study and your doctor will discuss other
treatment options with you. If you decide to stop participating in the study, you are
encouraged to discuss your decision with your study doctor.

For Patients Already Enrolled:

If you have already been enrolled on this study and were assigned to receive dasatinib twice
a day, you will be able to continue to receive the study drug on that schedule. However, if
you experience side effects, the study doctor may choose to switch you to the once daily
schedule if he feels that it may help to get rid of or decrease the risk of side effects.

This is an investigational study. Dasatinib is investigational and is approved by the FDA for
clinical trials only.

A total of 150 patients will take part in this study. All will be enrolled at MD Anderson.

Inclusion Criteria:

1. Diagnosis of Ph-positive or Bcr-Abl positive CML in early chronic phase CML (i.e.,
time from diagnosis received no or minimal prior therapy, defined as <1 month (30 days) of prior IFN-alpha
(with or without ara-C) and/or an FDA approved TKI

2. Continued from above #1: Clonal evolution defined as the presence of additional
chromosomal abnormalities other than the Ph chromosome has been historically been
included as a criterion for accelerated phase. However, patients with clonal evolution
as the only criterion of accelerated phase have a significantly better prognosis, and
when present at diagnosis may not impact the prognosis at all. Thus, patients with
clonal evolution and no other criteria for accelerated phase will be eligible for this
study

3. Age >/= 16 years (Age >18 years to participate in optional symptom burden assessment)

4. ECOG performance of 0-2

5. Adequate end organ function, defined as the following: total bilirubin <1.5 x ULN,
SGPT <2.5x ULN, creatinine <1.5x ULN

6. Patients must sign an informed consent indicating they are aware of the
investigational nature of this study, in keeping with the policies of the hospital.

7. Reliable telephone access to receive calls from an interactive voice response system
(IVR) (only applicable to patients who will participate in optional symptom burden
assessment)

Exclusion Criteria:

1. New York Heart Association (NYHA) cardiac class 3-4 heart disease

2. Cardiac Symptoms: Patients meeting the following criteria are not eligible unless
cleared by Cardiology: Uncontrolled angina within 3 months; Diagnosed or suspected
congenital long QT syndrome; Any history of clinically significant ventricular
arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or Torsades de
pointes); Prolonged QTc interval on pre-entry electrocardiogram (> 450 msec) on both
the Fridericia and Bazett's correction; Uncontrolled hypertension; History of
significant bleeding disorder unrelated to cancer, including:

3. Cont: Diagnosed congenital bleeding disorders (von Willebrand's disease) Diagnosed
acquired bleeding disorder w/in 1 year (acquired anti-factor VIII antibodies);Pts
currently taking drugs that are generally accepted to have a risk of causing Torsades
de Pointes including: quinidine, procainamide, disopyramide amiodarone, sotalol,
ibutilide, dofetilide erythromycins, clarithromycin chlorpromazine, haloperidol,
mesoridazine, thioridazine, pimozide cisapride, bepridil, droperidol, methadone,
arsenic, chloroquine, domperidone, halofantrine, levomethadyl, pentamidine,
sparfloxacin, lidoflazine.

4. Patients with active, uncontrolled psychiatric disorders including: psychosis, major
depression, and bipolar disorders

5. Women of pregnancy potential must practice 2 effective methods of birth control during
the course of the study, in a manner such that risk of failure is minimized.Prior to
study enrollment, women of childbearing potential (WOCBP) must be advised of the
importance of avoiding pregnancy during trial participation and the potential risk
factors for an unintentional pregnancy. Postmenopausal women must be amenorrheic for
at least 12 months to be considered of non-childbearing potential.

6. Continued: Women must continue birth control for the duration of the trial and at
least 3 months after the last dose of study drug; Pregnant or breast-feeding women are
excluded; All WOCBP MUST have a negative pregnancy test prior to first receiving
investigational product. If the pregnancy test is positive, the patient must not
receive investigational product and must not be enrolled in the study.

7. Patients in late chronic phase (i.e., time from diagnosis to treatment >12 months),
accelerated or blast phase are excluded.

8. The definitions of CML phases are as follows: a) Early chronic phase: time from
diagnosis to therapy > 12 months, b) Blastic phase: presence of 30% blasts or more in the peripheral blood
or bone marrow, c) Accelerated phase CML: presence of any of the following features:
•Peripheral or marrow blasts 15% or more, •Peripheral or marrow basophils 20% or more,
•Thrombocytopenia < 100 x 10^9/L unrelated to therapy, • Documented extramedullary
blastic disease outside liver or spleen