Rituximab+mVPDL for CD20(+) Adult Acute Lymphoblastic Leukemia

Inclusion Criteria: * Patients who were previously untreated and had either ALL or high-risk lymphoblastic lymphoma. * Patients whose leukemic blast cells express ≥20% of CD20 antigens at time of diagnosis * No prior chemotherapy for leukemia (use of hydroxyurea or leukapheresis are permitted.) * Estimated life expectancy of more than 3 months * ECOG performance status of 2 or lower, Karnofsky scale \> 60 * Adequate cardiac function (EF\>45%) on echocardiogram or Heart scan (MUGA scan) * 15 years of age and over. * Adequate renal function (creatinine\<1.5 mg/dL) * Adequate hepatic function. (Bilirubin\<1.5 mg/dL, transaminases levels\<3 times the upper normal limit \[5 times for patients with liver metastasis or hepatomegaly\]). Even the initial level exceed the upper limits, patient will be acceptable when the levels on day 8 satisfies the inclusion criteria. * All patients gave written informed consent according to guidelines at each institution's committee on human research. Exclusion Criteria: * Acute biphenotypic leukemia, acute biclonal leukemia, or acute mixed leukemia * Presence of significant uncontrolled active infection * Presence of uncontrolled bleeding * Any coexisting major illness or organ failure * Patients with psychiatric disorder or mental deficiency severe as to make compliance with the treatment unlike, and making informed consent impossible * Nursing women, pregnant women, women of childbearing potential who do not want adequate contraception * Patie…