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The adoption of pediatric\u2010derived, intensive lymphoblastic leukemia\u2010like protocols led to significantly improved results, with survival rates of about 70% and 90% in adults and children, respectively. Adequate central nervous system prophylaxis and mediastinal irradiation contributed to the therapeutic success; however, the role of radiation therapy is debated due to toxicity concerns and the excellent results obtained with radiation\u2010free programs especially in pediatric patients. With these modern schedules, localized radiotherapy and\/or hematopoietic stem cell transplants could be generally omitted, and considered only for high\u2010risk patients identified through postinduction computed tomography\/positron\u2010emission tomography scans, minimal residual disease analysis, and new genetics and genomics. 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