Obinutuzumab Versus Rituximab for Acute Lymphoblastic Leukemia/PALG ALL7 "OVERALL"

Inclusion Criteria:

1. Age ≥18 years.

2. Newly diagnosed Acute lymphoblastic leukemia with CD20 expression on at least 20% ofblasts.

3. Signed written informed consent.

4. Adequate contraception in case of women with child-bearing potential

Exclusion Criteria:

1. Lymphoblastic lymphoma with bone marrow blasts<20%.

2. Patients with a history of chronic myeloid leukemia or other myeloproliferativedisease.

3. Major surgery within 4 weeks before enrollment.

4. Impaired cardiac function: ejection fraction <40% on echocardiography, QTc interval > 450 ms on baseline electrocardiogram. Myocardial infarction within 6 months priorto starting study; other clinically significant heart disease (e.g. unstable angina,congestive heart failure or uncontrolled hypertension, uncontrolled arrhythmias).

5. Active infection e.g. hepatitis B virus, hepatitis C virus, human immunodeficiencyvirus

6. Other concurrent severe and/or uncontrolled medical conditions: patients withanother primary malignant disease, except those that do not currently requiretreatment; acute or chronic liver, pancreatic or severe renal disease; anothersevere and/or life-threatening medical disease.

7. Serum creatinine > 2 times the upper normal limit of the laboratory, totalbilirubin> 2.5 upper normal limit unless related to Acute lymphoblastic leukemia,aspartate aminotransferase or alanine aminotransferase > 5 upper normal limit,unless related to Acute lymphoblastic leukemia

8. Intolerance to treatment with monoclonal antibody.

9. Positive pregnancy test (beta human chorionic gonadotropin) for women ofchildbearing age.

10. Inability to obtain written informed consent.

11. Inability to comply with regular monitoring.