Combination Chemotherapy With or Without Donor Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia

Inclusion Criteria:

• Morphologic diagnosis of acute lymphoblastic leukemia (ALL) with evidence of involvement in bone marrow and/or blood

  • No extramedullary disease in the absence of bone marrow or blood involvement
  • Philadelphia chromosome (Ph)- and/or BCR/ABL-positive as confirmed by standard cytogenetics, FISH, and/or PCR
  • No minimally differentiated acute myeloid leukemia (M0), mixed lineage leukemia, or L3 (Burkitt) ALL

  • Lineage (B-cell, T-cell, or mixed B/T cell) must be determined

    • Appropriate marker studies, including CD19 (B-cell), CD10, CD5, and CD7 (T-cell) must be performed
    • Co-expression of myeloid antigens (CD13 and CD33) allowed
• Must be enrolled on clinical trials SWOG-9007, and ECOG-E3903 or CALGB-8461 (for ECOG and CALGB sites)

• Patients may have received no more than one course of remission induction therapy for ALL; patients who have received any post-remission therapy for ALL or who have relapsed from complete remission are not eligible; (patients with previously untreated ALL can be eligible, and patients who have received one course of remission induction therapy for ALL can be eligible, regardless of their response to therapy); patients may have received no more than 14 days of tyrosine kinase inhibitor therapy prior to registration; any prior induction chemotherapy must have been completed no more than 28 days prior to registration

  • NOTE: If the patient has been initiated on the protocol defined regimen (i.e. the hyperCVAD regimen without a Tyrosine kinase inhibitor) before the Ph/BCR-ABL status was known, the patient may be registered on the protocol and start dasatinib; in this first course, dasatinib will be administered up to Day 14 (i.e. if the patient is registered on Day 5 and starts therapy on Day 6, only 8 days of dasatinib will be administered and dasatinib will be completed on Day 14)
• No active pericardial effusion, ascites, or pleural effusion of any grade

• Available matched donor meeting the following criteria:

  • Completely matched (i.e., HLA-A, -B, DRβ1) sibling donor OR 10/10-matched non-sibling donor
  • Must not be monozygotic identical twin of patient
• Zubrod performance status 0-2
• Bilirubin ≤ 3.0 times upper limit of normal (ULN)
• AST and/or ALT ≤ 3.0 times ULN
• Serum creatinine ≤ 3.0 times ULN
• Patients must not be pregnant or nursing because of the teratogenic potential of the drugs used in this study; women/men of reproductive potential must have agreed to use an effective contraceptive method; a woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months; in addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation; however, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he/she is responsible for beginning contraceptive measures
• HIV-positive patients allowed except in transplantation portion of the study
• No prolonged QTc interval (QTc > 480 msec)

• No other prior malignancy except for any of the following:

  • Adequately treated basal cell or squamous cell skin cancer
  • In situ cervical cancer
  • Adequately treated stage I or II cancer from which the patient is currently in complete remission
  • Any other cancer from which the patient has been disease-free for 5 years
• No known history of type I hypersensitivity or anaphylactic reactions to doxorubicin
• More than 28 days since prior induction chemotherapy
• Collection and submission of pre-treatment cytogenetic specimens must be completed within 28 days prior to registration on S0805