Design and treatment sequences of blinatumomab-containing risk-oriented protocol GIMEMA LAL 2317. The primary study end point was an increased MRD negativity rate achieved at MRD TP 3 after blinatumomab 1 (blin 1). All CR patients underwent S-MRD between weeks 10 and 23 (TPs 2-4) to improve risk classification. According to the risk-oriented study strategy, the patients eligible for allo-HSCT had VHR ALL (regardless of S-MRD), a S-MRD⁺ SR or HR ALL, or HR ALL with unknown MRD; the patients eligible to receive standard consolidation/maintenance chemotherapy had S-MRD⁻ SR/HR ALL or a SR ALL with unknown MRD. 6-MP, 6-mercaptopurine; Ara-C, cytarabine; bd, twice daily (q12 h); cIV, continuous IV infusion; CY, cyclophosphamide; d, daily; Dex, dexamethasone; FAR, folinic acid rescue; IDR, idarubicin; IM, intramuscularly; IT, intrathecal CNS prophylaxis (MTX 12.5 mg, Ara-C 50 mg, Dex 4 mg or PDN 40 mg); max, maximum total dose; MTX, methotrexate; PEG-Asp, pegylated asparaginase; PDN, prednisone; PO, orally; SC, subcutaneously; VCR, vincristine.