Must-read medication: Dasatinib usage and dosage

For adult patients with chronic phase Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML), the recommended starting dose of dasatinib is 100 mg orally once daily. The recommended starting dose of dasatinib for accelerated phase CML, myeloid or lymphoblastic phase CML, or Ph+ acute lymphoblastic leukemia (ALL) is 140 mg orally once daily. Dasatinib tablets should not be crushed, cut, or chewed; they should be swallowed whole; patients may take them in the morning or evening with or without food.

(2) Pediatric patients: The recommended starting dose of dasatinib is based on body weight and should be taken orally once a day; the dose should be recalculated every 3 months based on changes in body weight, or more frequently if necessary. The dose is 40 mg for patients weighing 10-19 kg; 60 mg for patients weighing 20-29 kg; 70 mg for patients weighing 30-44 kg; and 100 mg for patients weighing at least 45 kg. Patients weighing less than 10kg are not recommended to take dasatinib tablets.

For adult patients withCML and Ph+ALL, consider increasing the dose to 140 mg once daily (chronic phase CML) or 180 mg once daily (advanced CML and Ph+ALL) for patients who do not achieve a hematologic or cytogenetic response at the recommended starting dose. For pediatric patients with CML, consider increasing the dose to 120 mg once daily; for pediatric patients with Ph+ ALL, a dose increase is not recommended because dasatinib is used in combination with chemotherapy.

In clinical studies, adult and pediatric patients with chronic-phase CML continue to receive dasatinib until disease progression or until patients no longer tolerate it. The impact of discontinuing treatment after achieving a cytogenetic response (including complete cytogenetic response [CCyR]) or major molecular response (MMR and MR4.5) on long-term disease outcomes has not been determined. In clinical studies, for pediatric patients with Ph+ ALL, treatment was initiated on or before day 15 of induction chemotherapy after diagnosis and continued for 2 years.