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Between July 2003 and March 2008, 111 newly diagnosed ALL paediatric patients were admitted to our hospital for treatment. The study was approved by our institutional review board. Informed consent was obtained from the guardians of all patients. The date of last follow-up was 30 July 2012. The diagnosis was http://www.selleck.cn/products/wortmannin.html established when at least 25% lymphoblasts were present in the bone marrow (BM). Central nervous system (CNS) disease (CNS3) was diagnosed the presence of ��5 cells/��l and morphologically identifiable lymphoblasts in the cerebrospinal fluid (CSF) on cytospin preparations, or cerebral infiltrations on cranial computed tomography/magnetic resonance imaging, or cranial nerve palsy. CNS status was classified as CNS2 when CSF cell count was ��5 cells/��l and lymphoblasts were identified in CSF cytospin preparations, or in the case of traumatic lumber puncture. Prednisone response was assessed by the absolute blast count (ABC) in the peripheral blood (PB) on day 8 after seven days of prednisone http://www.selleckchem.com/products/LY294002.html prephase and one intrathecal (IT) dose of methotrexate (MTX) on day 1. Patients with a day-8 ABC http://www.selleckchem.com/products/CHIR-99021.html and/or WBC ��20?��?109/l, M1 or M2 marrow on day 15, and M1 marrow on day 33; or fulfilling SR criteria, but with M3 marrow (>25% blasts) on day 15 and M1 marrow on day 33. (iii) High-risk group (HR): PPR, and/or M2 or M3 marrow on day 33, or fulfilling IR criteria with M3 marrow on day 15. Treatment was based on a modification of the ALL IC-BFM 2002 based protocol. In brief, all patients received a standard induction protocol I/I', consolidation/extracompartmental protocol mM, delayed intensification protocol III with interim maintenance phase and maintenance therapy. For all patients, the duration of therapy was 104?weeks. T-ALL patients ��1?year old received prophylactic cranial radiotherapy with 12?Gy. Patients ��2?years old with CNS3 received 18?Gy therapeutic cranial radiotherapy (12?Gy if aged ��1�C