Venetoclax and a Pediatric-Inspired Regimen for the Treatment of Newly Diagnosed B Cell Acute Lymphoblastic Leukemia

Inclusion Criteria: * Documented informed consent of the participant and/or legally authorized representative * Age between 18 and 54 years * Eastern Cooperative Oncology Group (ECOG) =\< 2 * Histologically confirmed B-cell ALL according to World Health Organization criteria * Note: Lymphoblastic leukemia is included as long as there is bone marrow involvement * Newly diagnosed disease with \>= 5% blasts in the marrow * White blood cell count less than 25 x 10\^9/L prior to initiation of venetoclax. Cytoreduction with hydroxyurea or steroid or a single dose of intrathecal chemotherapy prior to treatment may be required (performed within 14 days prior to day 1 of protocol therapy unless otherwise stated) * Total bilirubin =\< 1.5 X upper limit of normal (ULN) (unless has Gilbert's disease or underlying leukemia, =\< 3 X ULN) (performed within 14 days prior to day 1 of protocol therapy unless otherwise stated) * Aspartate aminotransferase (AST) =\< 2.5 x ULN (performed within 14 days prior to day 1 of protocol therapy unless otherwise stated) * Unless it is related to underlying leukemia * Alanine aminotransferase (ALT) =\< 2.5 x ULN (performed within 14 days prior to day 1 of protocol therapy unless otherwise stated) * Unless it is related to underlying leukemia * Creatinine clearance of \>= 60 mL/min per 24 hour urine test or the Cockcroft-Gault formula (performed within 14 days prior to day 1 of protocol therapy unless otherwise stated) * Left ventricular ejection …