Vyxeos(CPX-351) in Adults w R/R Acute Lymphoblastic Leukemia

Inclusion Criteria: * Willing and able to provide written informed consent/assent for the trial. * Be ≥ 18 years of age on day of signing informed consent. * Able to adhere to the study visit schedule and other protocol requirements. * Pathologically confirmed B- or T-cell acute lymphoblastic or mixed phenotype acute leukemia, with \>5% peripheral blood or bone marrow lymphoblasts and/or extramedullary disease \>1x1cm. * Relapsed or refractory acute lymphoblastic leukemia after at least 1 prior cycle of therapy. Patients with Philadelphia chromosome positive disease must have failed at least two prior tyrosine kinase inhibitors. * Eastern Cooperative Oncology Group (ECOG) performance status 0-1. * Cardiac ejection fraction ≥ 50% by echocardiography or multigated acquisition scan (MUGA). * Must be at least 2 weeks out from any prior systemic chemotherapy, blinatumumab, radiation, and/or other investigational agents, and have recovered to grade 1 from any toxicity related to prior therapy. Glucocorticoids are permitted up to 1 day prior to the first dose. * Serum bilirubin and creatinine less than 1.5x upper limit of normal (ULN). AST and ALT must be less than 3x ULN, unless there is suspected liver involvement. * Females of childbearing potential (FCBP) must have a negative serum pregnancy test at screening. A FCBP is considered when a sexually mature female: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at leas…