MRD-associated Non-intensive But Non-interruptive Treatment of Ph-negative Acute Lymphoblastic Leukemia Adult Patients

• 7 days prednisolone prephase
• 8 weeks induction with de-escalation of induction chemotherapy: 3 instead of 4 dauno/vncr pulses,

• instead of 2 Cph injections during induction,
• instead of 4 ARA-C blocks, distribution of of L-asp injections through all phases
• After CR achievement T-cell ALL and B-ALL patients are being study MRD (by FCM) MRD-positive patients with T-ALL will receive 1-3 consolidation with venetoclax (400 mg/d), and B-ALL patients will receive1 additional consolidation by blinatumomab
• Non-interruptive 5 consolidation phases with dose modification according to WBC and platelets count after CR achievement. Rotation of consolidation is permitted
• 2 years maintenance for all patients
• 21 TIT through the whole treatment with higher intensity during induction|consolidation
• Centralized MRD monitoring at +70 d, + 133 d, + 190 days; before and after allo-HSCT
• Allo-HSCT is planned only for very high risk patients (11q23 ALL, MRD positivity after target therapy, ETP T-ALL)

Inclusion criteria

• age 18-55 years old of patient,

• Clinical diagnosis of non-treated Ph-negative ALL

Exclusion criteria

• age more than 55 years old,

• Clinical diagnosis of Ph-positive ALL
• Clinical diagnosis of relapsed/refractory ALL,