Standard Sprycel Dosing for CML
Sprycel (dasatinib) dosing for chronic myeloid leukemia (CML) depends on disease phase and patient factors like age or response. Adults start at 100 mg once daily for chronic phase CML and 140 mg once daily for accelerated or blast phase CML, taken orally with or without food.[1]
Dosing by CML Phase
- Chronic phase CML (newly diagnosed or resistant/intolerant): 100 mg once daily. Reduce to 80 mg if needed for toxicity.
- Accelerated or blast phase CML (resistant/intolerant): 140 mg once daily. Reduce to 100 mg (accelerated) or 120 mg (blast) if toxicity occurs.[1]
Adjustments for Children (Pediatric CML)
For ages 1 year and older:
- Chronic phase: 80 mg/m² once daily (max 140 mg).
- Advanced phase: 140 mg/m² once daily (max 280 mg).[1]
Common Dose Modifications
Reduce dose for side effects like neutropenia, thrombocytopenia, or pleural effusion. Interrupt therapy until recovery, then restart at lower dose (e.g., 80 mg or 40 mg). Avoid strong CYP3A4 inhibitors/inducers, which alter levels—adjust dose accordingly.[1]
Treatment Duration and Monitoring
Continue until disease progression, intolerance, or transplant. Monitor blood counts weekly initially, then monthly; check for pleural effusion via exam or imaging.[1]
[1]: Sprycel Prescribing Information