Therapy for Newly Diagnosed Patients With B-Cell Precursor Acute Lymphoblastic Leukemia and Lymphoma

This study tests an intensive treatment regimen for children and young adults with high-risk B-cell acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma (LBL) — blood and lymph node cancers that require aggressive treatment when they present with certain high-risk features. The study builds on an earlier baseline study (called INITIALL) and offers more intensive therapy for patients whose cancer is considered higher risk based on specific clinical or biological factors. **You may be eligible if...** - You are 1 to 18 years old and previously enrolled in the INITIALL study - You have B-cell ALL or lymphoblastic lymphoma - You meet at least one high-risk feature: older age (10+), high white blood cell count at diagnosis, cancer in the brain or spinal fluid, testicular involvement, certain steroid pre-treatment, or stage 3-4 lymphoblastic lymphoma - Your liver and kidney function meet the minimum required levels **You may NOT be eligible if...** - You did not enroll in the INITIALL study - You received chemotherapy outside of what is allowed by INITIALL - You do not meet the high-risk clinical criteria described - Your liver or kidney function is below the required thresholds Talk to your doctor to see if this trial is right for you.