At a press conference during the 2014 American Society of Hematology (ASH) Annual Meeting, Dr Brent Wood (University of Washington, Seattle, WA) discusses the phase III Children’s Oncology Group (COG) study AALL0434, which evaluated a standard 4-drug induction followed by response-based risk stratification, as determined by measured levels of minimal residual disease (MRD), in patients with T-lymphocytic leukaemia. Intermediate and high-risk patients were randomised to receive or not receive additional nelarabine chemotherapy and all patients except those who were low-risk received additional radiation therapy.