Calaspargase Pegol or Pegaspargase and Combination Chemotherapy in Treating Younger Patients With Newly Diagnosed High-Risk Acute Lymphoblastic Leukemia

Inclusion Criteria:

   - Patients must be eligible for and enrolled on AALL08B1 or the successor classification
   study

   - Patients must have newly diagnosed high-risk B lymphoblastic leukemia (World Health
   Organization [WHO] 2008 classification) (also termed B-precursor acute lymphoblastic
   leukemia)

   - White blood cell (WBC) >= 50,000/μL for patients age 1-9 OR any WBC count for patients
   age 10-30 or for patients treated with prior steroids

   - 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 CNS status must be determined based on a sample obtained prior to
   administration of any systemic or intrathecal chemotherapy, except for steroid
   pretreatment) systemic chemotherapy must begin within 72 hours of this intrathecal
   therapy

   - Patients receiving prior steroid therapy are eligible for this study; the dose and
   duration of previous steroid therapy should be carefully documented

   - Pregnancy tests with a negative result must be obtained in all post-menarchal females

   - Lactating females must agree that they will not breastfeed a child while on this study

Exclusion Criteria:

   - Patients with Down syndrome are excluded from this study

   - Patients with testicular leukemia at diagnosis are excluded from this study

   - Pregnant female patients are excluded from this study