• T-ALL: T-ALL patients must be enrolled on AALL08B1 or Project:EveryChild (APEC14B1, if open for the classification of ALL patients) prior to treatment and enrollment on AALL1231

• All patients must be > 1 and < 31 years of age

• Patients must have newly diagnosed T-lymphoblastic leukemia (T-ALL) or T-lymphoblastic lymphoma (T-LLy) stages II-IV

  • Note: a diagnosis of T-ALL is established when leukemic blasts
   lack myeloperoxidase or evidence of B-lineage derivation (cluster
   of differentiation [CD]19/CD22/CD20), and express either surface
   or cytoplasmic CD3 or two or more of the antigens CD8, CD7,
   CD5, CD4, CD2 or CD1a, and are present either in peripheral
   blood or > 25% in the bone marrow; if surface CD3 is expressed
   on all leukemic cells, additional markers of immaturity, including
   terminal deoxynucleotidyl transferase (TdT), CD34 or CD99 will
   be assessed for expression; cases with uncertain expression will
   receive additional review within the appropriate Children's
   Oncology Group (COG) reference laboratory

  • For T-LLy patients with tissue available for flow cytometry, the
   criterion for diagnosis should be analogous to T-ALL; for tissue
   processed by other means (i.e. paraffin blocks), the methodology
   and criteria for immunophenotypic analysis to establish the
   diagnosis of T-LLy defined by the submitting institution will be
   accepted

• All patients and/or their parents or legal guardians must sign a written informed consent; assent, when appropriate, will be obtained according to institutional guidelines

• Patients must not have received any cytotoxic chemotherapy for either the current diagnosis of T-ALL, T-L-Ly or for any cancer diagnosis prior to the initiation of protocol therapy on AALL1231, with the exception of:

  • Steroid pretreatment: prednisone or methylprednisolone for =<
   120 hours (5 days) in the 7 days prior to initiating induction
   chemotherapy or for =< 336 hours (14 days) in the 28 days prior
   to initiating induction chemotherapy; prior exposure to ANY   
   steroids that occurred > 28 days before the initiation of protocol
   therapy does not affect eligibility; the dose of prednisone or
   methylprednisolone does not affect eligibility

  • Intrathecal cytarabine (the CNS status must be determined based
   on a sample obtained prior to administration of any systemic or
   intrathecal chemotherapy, except for steroid pretreatment) system
   chemotherapy must begin with 72 hours of this IT therapy; or

  • Pretreatment with hydroxyurea; or

  • 600 cGy of chest irradiation, if medically necessary

    • Pre-treatment with dexamethasone in the 28 days prior to
     initiation of protocol therapy is not allowed with the exception
     of a single dose of dexamethasone use during sedation to
     prevent or treat airway edema; inhalation steroids and
     topical steroids are not considered pretreatment

• Pre-existing >= grade 2 sensory or motor peripheral neurotoxicity

• Uncontrolled seizure disorder

• Diagnosis of Down syndrome (Trisomy 21)

• Patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs; a pregnancy test is required for female patients of childbearing potential

• Lactating females who plan to breastfeed

• Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation

• Patient has hypersensitivity to bortezomib, boron, or mannitol

• Serious medical or psychiatric illness likely to interfere with participation in this clinical study

• Participation in clinical trials with other investigational agents not included in this trial, within 14 days of the start of this trial and within 30 days of any dose of bortezomib

• Hematologic Diseases

• Immune System Diseases

• Immunoproliferative Disorders

• Leukemia

• Leukemia

• Lymphatic Diseases

• Lymphoid

• Lymphoma

• Lymphoproliferative Disorders

• Neoplasms

• Neoplasms by Histologic Type

• Non-Hodgkin

• Oncology (Pediatrics)

• Precursor Cell Lymphoblastic Leukemia-Lymphoma

• Precursor T-Cell Lymphoblastic Leukemia-Lymphoma

• Lymphoma

• Oncology (Adult)

• National Cancer Institute (NCI)