Treatment of Newly Diagnosed Acute Lymphoblastic Leukemia in Children and Adolescents

Arm A: Standard/Fixed Dose Pegaspargase (2500 IU/m2 every 2 weeks) Arm B: Reduced Dose (PK-adjusted) Pegaspargase (Starting Dose: 2000 IU/m2) Arm X: Directly Assigned Standard Dose (2500 IU/m2): For all VHR and patients who decline randomization

Only for patients with Pegaspargase allergy or silent inactivation.

Standard of Care

Standard of Care

Standard of Care

Standard of Care

Standard of Care

Standard of Care

Standard of Care

Standard of Care

Standard of Care

Standard of Care

Standard of Care

Standard of Care

Standard of Care