Disease-free survival (DFS) and overall survival (OS) comparisons for nelarabine versus no nelarabine in the randomized cohorts. (A) Five-year DFS rates were 88.2% ± 2.4% with nelarabine compared with 82.1% ± 2.7% without nelarabine (P = .029). (B) Five-year OS rates were 90.3% ± 2.2% with nelarabine compared with 87.9% ±without nelarabine (P = .168). (C) Five-year DFS rates for the 4 randomized arms were as follows: escalating-dose methotrexate without leucovorin rescue plus pegaspargase (C-MTX) with nelarabine, 91.4% ± 3.1% (n = 147); C-MTX without nelarabine, 87.2% ± 3.5% (n = 151); high-dose methotrexate with leucovorin rescue (HDMTX) with nelarabine, 85.5% ± 3.6% (n = 176); and HDMTX without nelarabine, 78.1% ± 4.0% (n = 185; P = .01). (D) DFS by age group in patients randomly assigned to nelarabine; 5-year DFS rates were as follows: age < 10 years, 87.1% ± 3.5%; age 10-15 years, 91.3% ± 3.7%; and age ≥ 16 years, 84.8% ± 7.1% (P = .77). (E) DFS by age group in patients not randomly assigned to nelarabine; 5-year DFS rates were as follows: age < 10 years, 80.3% ± 3.8%; age 10-15 years, 81.9% ± 4.9%; and age ≥ 16 years, 88.6% ± 5.5% (P = .441).