Treatment for Ph-negative ALL for Adults up to 65 Years

Inclusion Criteria: * De novo ALL. * Age 18-65 years. * No prior treatment, except: Urgent leukapheresis, Urgent treatment of hyperleukocytosis with hydroxyurea, Urgent cranial irradiation (one dose) for CNS leukostasis, Urgent mediastinal irradiation for superior vena cava syndrome. * Adequate general condition (ECOG score 0-2), or \>2 if due to ALL. * Negative pregnancy test for women of childbearing age. Exclusion Criteria: * Age \> 65 years. * ALL type L3 or with mature B phenotype (sIg+) or with the cytogenetic alterations characteristic of mature B-cell ALL (t(8;14), t(2;8), t(8;22)). * Ph-positive B-cell ALL (BCR::ABL1). * Lymphoid blast crisis of chronic myeloid leukemia. * Patients with a history of coronary artery disease, valvular heart disease, or hypertensive heart disease, which contraindicates the use of anthracyclines. * Patients with active chronic liver disease. * Patients with severe chronic respiratory failure. * Renal insufficiency not due to ALL. * Severe neurological disorders, not due to ALL, that contraindicate the use of these treatments (especially blinatumomab). * History of clinically significant pancreatitis, at the investigator's discretion (taking into account the date of the pancreatitis, its previous severity, and sequelae). * Pregnancy or breastfeeding. * Psychiatric or mental illness that prevents providing informed consent for sample submission or adequately participating in the study. * Impaired general health (ECOG scores 3 and 4) n…