This study provides a 6-drug induction therapy to children with B-lymphoblastic leukemia (ALL) or localized B-lineage acute lymphoblastic lymphoma. Participants are stratified into 1 of 4 risk groups: Low Risk (LR), Average Risk (AR), High Risk (HR), and Very High Risk (VHR). At the end of induction, children with standard risk will be further classified as low risk (LR) or average risk (AR). AR participants will then be randomized to 1 of 4 maintenance regimens. (Participants on all arms will receive intrathecal [IT - given through a vein inserted through the back into the fluid surrounding the spinal cord] methotrexate every 12 weeks during maintenance, and the duration of therapy will continue to be gender-based). In addition, LR participants will be randomized to one of two treatment arms.
B-ALL patients must be enrolled in AALL08B1 prior to treatment on this study
Age older than one year and less than 10 years old for B-ALL, and older than one year and less than 30 for B-LLy
B-ALL patients must have appropriate white blood cell count
Newly diagnosed B- ALL or B-LLy Murhy Stages 1 or II; Down syndrome patients also eligible
B-ALL patients with testicular leukemia are not eligible