Identification of Necessary Information for Treatment Induction in Newly Diagnosed Acute Lymphoblastic Leukemia/Lymphoma

Inclusion Criteria:

• Age 1-18.99 years

• Diagnosis of acute leukemia / lymphoma as below:

• Acute lymphoblastic leukemia (ALL) with at least 25% bone marrow blasts ordefinitive evidence of ALL in peripheral blood (in those without an availablebone marrow sample).

• Lymphoblastic lymphoma (LLy) with immunophenotypic evidence of a lymphoblasticpopulation and <25% bone marrow blasts and less than 1,000 circulating blasts/microL.

• Mixed phenotype acute leukemia (MPAL) with or without 25% bone marrowinvolvement (i.e. patients with either leukemia or lymphoma are eligible).

Exclusion Criteria:

• Pregnant or breastfeeding

• Receipt of prior cancer directed therapy with the exclusion of up to 1 dose ofintrathecal chemotherapy, 1 dose of vincristine, or emergency radiotherapy due toorgan compromising malignant mass. There is no exclusion for prior steroid therapy.

• Known to be currently ineligible for available SJALL therapeutic studies (e.g.receipt of prohibited therapy, no appropriate SJALL therapeutic study available,enrolled on competing trial, etc.).

Note: The intention of this exclusion criterion is to enroll all newly diagnosed ALL/ LLy/ MPAL patients. If participant is screened as a potential participant for subsequent SJALL and later found to be ineligible due to information obtained during INITIALL, this will not make the participant ineligible for INITIALL.

• Inability or unwillingness of research participant or legal guardian/representativeto give written informed consent.

• Major pre-existing abnormalities such as ataxia telangiectasia, Fanconi anemia,Charcot Marie Tooth, etc.