Nilotinib and Imatinib Mesylate After Donor Stem Cell Transplant in Treating Patients With ALL or CML

Inclusion Criteria:

   - Body surface area >= 1 m^2

   - Allogeneic HCT

   - Acute lymphocytic leukemia (ALL) or chronic myelogenous leukemia (CML) characterized
   by the p190 and/or p210 BCR/ABL gene rearrangement

   - CML in accelerated phase, blast crisis, or blast crisis remission as defined by World
   Health Organization (WHO) criteria

   - CML in chronic phase if patient age =< 17 years or a patient of any age with CML in
   second chronic phase or beyond

   - Patients with minimal residual disease (MRD) that is not declining in response to
   tyrosine kinase inhibitor therapy must be screened for the T315I and other mutations

   - An appropriately matched related or unrelated donor

   - Signed informed consent

   - Patient must have a life expectancy of at least 2 months

   - Stated willingness of the patient to comply with study procedures and reporting
   requirements

   - Creatinine =< 2.0 x upper limit normal (ULN)

   - Platelets > 20 x 10^9 /L

   - Serum aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =< 3 x ULN,
   conjugated bilirubin < 3 x ULN

   - Serum potassium phosphorus, magnesium, and calcium >= lower limit normal (LLN) or
   correctable with supplements prior to first dose of study drug; calcium levels may be
   corrected for hypoalbuminemia

   - Serum amylase and lipase < 1.5 x ULN

   - Female patients of childbearing potential must have negative pregnancy test within 7
   days before initiation of study drug dosing; postmenopausal women must be amenorrheic
   for at least 12 months to be considered of non-childbearing potential; male and female
   patients of reproductive potential must agree to employ an effective barrier method of
   birth control throughout the study and for up to 3 months following discontinuation of
   study drug

   - Careful rationalization with a view to discontinuing or considering alternatives to
   any concomitant medications that have potential to prolong the QT interval

Exclusion Criteria:

   - Autologous transplant

   - Non-myeloablative transplant

   - Patient age > 17 years with CML in first chronic phase

   - Aberrant antigen expression on marrow leukemic blasts >= 5% by multidimensional flow
   cytometric assay immediately before conditioning (CML patients in chronic phase exempt
   from flow cytometry screening)

   - Ph+ ALL without complete cytogenetic remission immediately before conditioning

   - Known T315I mutation

   - Hypersensitivity to Gleevec or Tasigna

   - Patients who are Tasigna-resistant or intolerant

   - Central nervous system (CNS) involvement with leukemia at baseline (pre-imatinib
   therapy); CML chronic phase (CP), accelerated phase (AP) patients exempt from CNS
   involvement screening

   - Female patients who are pregnant, breast-feeding, or of childbearing potential without
   a negative serum pregnancy test at screening; male or female patients of childbearing
   potential unwilling to use effective contraceptive precautions throughout the trial;
   post-menopausal women must be amenorrheic for at least 12 months to be considered of
   non-childbearing potential

   - Life expectancy severely limited by diseases other than leukemia

   - Myocardial infarction within one year prior to starting nilotinib

   - Other clinically significant heart disease (e.g. congestive heart failure,
   uncontrolled hypertension, unstable angina)

   - Absolute neutrophil count (ANC) less than 1500 per microliter at study entry despite
   the use of filgrastim (G-CSF)

   - Impaired cardiac function, including any one of the following:

      - Complete left bundle branch block or bifascicular block (right bundle branch
      block plus left anterior hemiblock) or use of ventricular-paced pacemaker

      - Congenital long QT syndrome or a family history of long QT syndrome

      - History of or presence of significant ventricular or atrial tachyarrhythmias

      - Clinically significant resting bradycardia (< 50 beats per minute)

   - Corrected QT interval (QTc) > 450 milliseconds on screening electrocardiogram (ECG);
   if QTc > 450 and electrolytes are not within normal ranges, electrolytes should be
   corrected and then the patient rescreened for QTc