Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Acute Lymphoblastic Leukemia

Inclusion Criteria:

   - Patients must be enrolled on AALL03B1 prior to enrollment on AALL0331

   - Initial white blood cells (WBC) < 50,000/ul

   - Newly diagnosed B-precursor acute lymphoblastic leukemia

      - Standard-risk (SR) disease meeting 1 of the following criteria:

      - SR-average by age and WBC

      - No unfavorable features

      - Rapid early responder (RER) by day 15

      - CNS 1 or 2

      - Minimal residual disease (MRD) negative on day 29

      - Trisomies of 4, 10, and 17 or TEL-AML1 translocation and RER and CNS2 allowed

      - SR-low by age and WBC

      - No unfavorable features

      - RER by day 15

      - MRD negative on day 29

      - CNS1

      - Favorable cytogenetics-trisomies of 4, 10, and 17 or TEL-AML translocation

      - SR-high

      - Unfavorable features meeting ≥ 1 of the following criteria:

         - MLL rearrangements and RER

         - Steroid pretreatment

         - CNS3

         - Slow early responder by morphology or MRD

   - Patients with Down syndrome are allowed

   - Patients with overt testicular disease are not eligible for this study, but may be
   eligible for AALL0232

   - Patients shall have had no prior cytotoxic chemotherapy with the exception of steroids
   and intrathecal cytarabine; intrathecal chemotherapy with cytarabine is allowed prior
   to registration for patient convenience; this is usually done at the time of the
   diagnostic bone marrow or venous line placement to avoid a second lumbar puncture;
   (Note: the central nervous system [CNS] status must be determined based on a sample
   obtained prior to administration of any systemic or intrathecal chemotherapy, except
   for steroid pretreatment

   - Patients receiving prior steroid therapy may be eligible for AALL0331 study

   - Patients with a contraindication to additional asparaginase therapy, following
   Induction, are not eligible for the Standard Risk-Low study, and should be removed
   from protocol therapy at the end of Induction

   - Patients who are assigned to the standard risk-average group following Induction and
   who meet the HRQOL

   - Age at diagnosis >= 2 years (note that this is a more restrictive age range than for
   the therapeutic component of the study)

   - At least one parent with reading comprehension of English or Spanish languages for
   which validated surveys exist

   - Diagnosis at one of the institutions participating in this limited institution
   correlative study

   - A parent or legal guardian must sign a written informed consent/parental permission
   for all patients

   - All institutional, Food and Drug Administration (FDA), and National Cancer Institute
   (NCI) requirements for human studies must be met