Phase II Study of Combination of Hyper-CVAD and Dasatinib With or Without Allogeneic Stem Cell Transplant in Patients With Philadelphia (Ph) Chromosome Positive and/or Bcr-Abl Positive Acute Lymphoblastic Leukemia (ALL) (A BMT Study).

Inclusion Criteria:

- Patients must have a morphologic diagnosis of acute lymphoblastic leukemia (ALL),
with evidence of ALL involvement in bone marrow and/or blood; patients with only
extramedullary disease in the absence of bone marrow or blood involvement are not
eligible; patients with M0 acute myeloid leukemia (AML) or mixed lineage leukemia are
not eligible for this study; patients with L3 (Burkitts) are also not eligible

- For ALL in marrow or peripheral blood, immunophenotyping of the blood or marrow
lymphoblasts must be performed to determine lineage (B cell, T-cell, or mixed
B/T cell); NOTE: appropriate marker studies including CD19 (B cell), CD10, CD5,
and CD7 (T cell) must be performed; co-expression of myeloid antigens (CD13 and
CD33) will not exclude patients; if possible, the lineage specific markers
cytoplasmic CD22 or CD79a (B cells), cytoplasmic CD3 (T cells) and cytoplasmic
MPO (myeloid cells) must be determined

- 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
Philadelphia chromosome (Ph)/breakpoint cluster region (BCR)-Abelson murine
leukemia viral oncogene (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)

- For patients who have received any prior therapy that was NOT remission induction
therapy, one of the following must be true:

- At least 6 weeks must have elapsed since any monoclonal antibodies were given,
at least 7 days must have elapsed since any other treatment was given, and all
toxicities of the remission induction therapy must have resolved to grade =< 2

- The patient must have rapidly progressive disease (per institutional guidelines)

- For previously treated patients, the Study Chair must be contacted before
registration, in order to determine the regimen to be given in the first course of
induction/consolidation therapy, based on prior therapy

- Patients must be Ph positive and/or BCR/ABL positive as confirmed by standard
cytogenetics, fluorescent in situ hybridization (FISH), and/or polymerase chain
reaction (PCR) testing performed by local laboratory; NOTE: samples will be submitted
centrally for verification of results

- Patients must have a bilirubin =< 3.0 x institutional upper limit of normal (IULN)
within 14 days prior to registration

- Patients must have serum glutamic oxaloacetic transaminase (SGOT) (aspartate
aminotransferase [AST]) =< 3.0 x IULN and/or serum glutamate pyruvate transaminase
(SGPT) (alanine aminotransferase [ALT]) =< 3.0 x IULN within 14 days prior to
registration; if both tests are done then both values must be =< 3.0 x IULN

- Patients must have a serum creatinine =< 3.0 x IULN within 14 days prior to
registration

- Patients must not have active pericardial effusion, ascites, or pleural effusion of
any grade; exception: if the effusion is suspected to be related to the leukemia, the
patient may have pericardial effusion of =< grade 2 or pleural effusion =< grade 1

- Patients may not have any clinically significant cardiovascular disease including the
following:

- Myocardial infarction or ventricular tachyarrhythmia within 6 months

- Prolonged corrected QT (QTc) > 480 msec (Fridericia correction)

- Ejection fraction less than institutional normal

- Major conduction abnormality (unless a cardiac pacemaker is present)

- Patients with any cardiopulmonary symptoms of unknown cause (e.g. shortness of
breath, chest pain, etc.) should be evaluated by a baseline echocardiogram with
or without stress test as needed in addition to electrocardiogram (EKG) to rule
out QTc prolongation; the patient may be referred to a cardiologist at the
discretion of the principal investigator; patients with underlying
cardiopulmonary dysfunction should be excluded from the study

- Patients must have Zubrod performance status of 0-2

- No other prior malignancy is allowed except for 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, or
any other cancer from which the patient has been disease-free for 5 years

- Collection and submission of pre-treatment cytogenetic specimens must be completed
within 28 days prior to registration on S0805

- Collection and submission of pretreatment marrow and/or peripheral blood specimens
for cellular and molecular studies, including verification of BCR/ABL status must be
completed within 28 days prior to registration

- 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

- Patients must not have prior history of known type I hypersensitivity or anaphylactic
reactions to doxorubicin

- Patients or their legally authorized representative must be informed of the
investigational nature of this study and must sign and give written informed consent
in accordance with institutional and federal guidelines

- At the time of patient registration, the treating institution's name and
identification (ID) number must be provided to the Data Operations Center in Seattle
in order to ensure that the current (within 365 days) date of institutional review
board approval for this study has been entered into the data base