PRIMARY OBJECTIVES:

      I. To compare event-free survival (EFS) in patients with newly diagnosed T-cell acute
      lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LLy) who are randomized
      to a modified augmented Berlin-Frankfurt-Munster (ABFM) backbone versus bortezomib plus the
      modified ABFM backbone.

      SECONDARY OBJECTIVES:

      I. To determine the safety and feasibility of modifying standard therapy for T-ALL and T-LLy
      based on the results of UKALL 2003, which includes a dexamethasone-based induction,
      additional doses of pegaspargase (PEG-ASP) during induction and delayed intensification (DI),
      and dexamethasone pulses during maintenance therapy.

      II. To determine if prophylactic (presymptomatic) cranial radiation therapy (CRT) can be
      safely and effectively eliminated in the 85-90% of T-ALL patients classified as standard or
      intermediate risk.

      III. To determine the proportion of end of consolidation (EOC) minimal residual disease (MRD)
      >= 0.1% T-ALL patients who become MRD negative (undetectable by flow cytometry) after
      intensification of chemotherapy, using three high risk (HR) BFM blocks, and to compare EFS
      between the patients who become MRD negative after the three HR BFM blocks and continue on
      chemotherapy with those who continue to have detectable MRD and are eligible for other
      treatment strategies, including hematopoietic stem cell transplant (HSCT).

      IV. To compare the EFS between very high risk (induction failure) T-LLy patients treated with
      HR BFM intensification blocks who have partial or complete response (PR or CR) with those who
      do not respond (NR).

      CORRELATIVE OBJECTIVES:

      I. To investigate the prognostic significance of day 29 bone marrow (BM) MRD in T-LLy
      patients.

      II. To determine if protein expression patterns can predict bortezomib response and drug
      resistance in T-ALL.

      III. To analyze and target relevant signaling pathways in T-ALL blasts, focusing on early T
      cell precursor (ETP) acute lymphoblastic leukemia (ALL).

      OUTLINE: Patients are randomized to 1 of 2 treatment arms.

      INDUCTION ARM A: Patients receive cytarabine intrathecally (IT) at time of diagnostic lumbar
      puncture (if within 72 hours from start of protocol therapy) OR day 1; vincristine sulfate
      intravenously (IV) over 1 minute on days 1, 8, 15, and 22; dexamethasone orally (PO) twice
      daily (BID) on days 1-28 (no taper); daunorubicin hydrochloride IV over 1-15 minutes on days
      1, 8, 15, and 22; pegaspargase IV over 1-2 hours on days 4 and 18; and methotrexate IT on
      days 8 and 29 (and on days 15 and 22 for central nervous system 3 involvement [CNS3] T-ALL
      patients).

      INDUCTION ARM B: Patients receive bortezomib IV over 3-5 seconds on days 1, 4, 8, and 11; and
      cytarabine, vincristine sulfate, dexamethasone, daunorubicin hydrochloride, pegaspargase, and
      methotrexate as in Induction Arm A.

      CONSOLIDATION: Beginning on day 36 from Induction, patients receive methotrexate IT on days
      1, 8, 15, and 22 (days 1 and 8 only for CNS3 T-ALL or CNS3 T-LLy patients); cyclophosphamide
      IV over 30-60 minutes on days 1 and 29; cytarabine IV over 1-30 minutes or subcutaneously
      (SC) on days 1-4, 8-11, 29-32, and 36-39; mercaptopurine PO once daily (QD) on days 1-14 and
      29-42; pegaspargase IV over 1-2 hours on days 15 and 43; and vincristine sulfate IV on days
      15, 22, 43, and 50. Patients with persistent testicular disease undergo radiation therapy.

      Patients are then assigned to subsequent therapy according to risk assignment. Patients with
      standard risk (SR) disease receive Interim Maintenance with Capizzi methotrexate (CMTX);
      patients with intermediate risk (IR) disease receive Interim Maintenance with high-dose
      methotrexate (HDMTX), Delayed Intensification, and then Interim Maintenance with CMTX; and
      patients with very high risk (VHR) disease receive 3 HR Intensification Blocks, Delayed
      Intensification, and then Interim Maintenance with CMTX.

      CMTX INTERIM MAINTENANCE: Patients receive vincristine sulfate IV over 1 minute on days 1,
      11, 21, 31, and 41; methotrexate IV over 2-5 minutes (undiluted) or 10-15 minutes (diluted)
      on days 1, 11, 21, 31, and 41; pegaspargase IV over 1-2 hours on days 2 and 22; and
      methotrexate IT on days 1 and 31. The next course (based on risk assignment) begins on day 57
      or when blood counts recover (whichever occurs later).

      DELAYED INTENSIFICATION ARM A: Patients receive vincristine sulfate IV over 1 minute on days
      1, 8, 15, 43, and 50; dexamethasone PO BID or IV on days 1-7 and 15-21; doxorubicin
      hydrochloride IV over 15 minutes on days, 1, 8, and 15; pegaspargase IV over 1-2 hours on
      days 4, 18, and 43; methotrexate IT on days 1, 29, and 36; cyclophosphamide IV over 30-60
      minutes on day 29; cytarabine IV over 1-30 minutes or SC on days 29-32 and 36-39; and
      thioguanine PO on days 29-42. The next course (based on risk assignment) begins on day 64 or
      when blood counts recover (whichever occurs later).

      DELAYED INTENSIFICATION ARM B: Patients receive bortezomib IV over 3-5 seconds on days 1, 4,
      15, and 18; and vincristine sulfate, dexamethasone, doxorubicin hydrochloride, pegaspargase,
      methotrexate, cyclophosphamide, cytarabine, and thioguanine as in Delayed Intensification Arm
      A. The next course (based on risk assignment) begins on day 64 or when blood counts recover
      (whichever occurs later).

      HDMTX INTERIM MAINTENANCE: Patients receive high-dose methotrexate IV over 24 hours on days
      1, 15, 29, and 43; leucovorin calcium IV or PO on days 3-4, 17-18, 31-32, and 45-46;
      vincristine sulfate IV on days 1, 15, 29, and 43; mercaptopurine PO QD on days 1-56; and
      methotrexate IT on days 1 and 29. The next course (based on randomization assignment) begins
      on day 57 or when blood counts recover (whichever occurs later).

      INTENSIFICATION BLOCK I: Patients receive dexamethasone IV or PO BID on days 1-5; high-dose
      methotrexate IV over 24 hours on day 1; leucovorin calcium IV or PO on days 3-4; vincristine
      sulfate IV on days 1 and 6; cyclophosphamide IV over 1-6 hours on days 2-4; high-dose
      cytarabine IV over 3 hours every 12 hours on day 5; pegaspargase IV over 1-2 hours on day 6;
      and triple IT therapy comprising methotrexate IT, hydrocortisone IT, and cytarabine IT on day
      1. The next course (Intensification Block II) begins on day 22 or when blood counts recover
      (whichever occurs later).

      INTENSIFICATION BLOCK II: Patients receive dexamethasone PO BID or IV on days 1-5; high-dose
      methotrexate IV over 24 hours on day 1; leucovorin calcium PO or IV on days 3-4; vincristine
      sulfate IV on days 1 and 6; ifosfamide IV over 1 hour every 12 hours on days 2-4;
      daunorubicin hydrochloride IV over 30 minutes on day 5; pegaspargase IV over 1-2 hours on day
      6; and triple IT therapy on day 1 as in Intensification Block I. The next course
      (Intensification Block III) begins on day 22 or when blood counts recover (whichever occurs
      later).

      INTENSIFICATION BLOCK III: Patients receive dexamethasone PO BID or IV on days 1-5; high-dose
      cytarabine IV over 3 hours every 12 hours on days 1-2; etoposide IV over 1-2 hours every 12
      hours on days 3-5; pegaspargase IV over 1-2 hours on day 6; and triple IT therapy on day 5 as
      in Intensification Block I. The next course (based on randomization) begins on day 22 or when
      blood counts recover (whichever occurs later).

      MAINTENANCE THERAPY: All patients receive vincristine sulfate IV over 1 minute on days 1, 29,
      and 57; dexamethasone PO BID or IV on days 1-5, 29-33, and 57-61; mercaptopurine PO on days
      1-84; methotrexate PO on days 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78 (omit day 29 for
      SR patients during the first 4 cycles); methotrexate IT on day 1 (and day 29 during the first
      4 cycles for SR patients and during the first 2 cycles for IR patients). Patients with
      CNS1-3VHR and CNS2 VHR, and CNS3 IR disease also undergo cranial radiation therapy during the
      first 4 weeks (cycle 1). Treatment in female patients with T-ALL and patients with T-LLY
      repeats every 12 weeks for up to 2 years from the start of Interim Maintenance (week 119).
      Treatment in male patients with T-ALL repeats every 12 weeks for up to 3 years from the start
      of Interim Maintenance (week 171).

      All treatment continues in the absence of disease progression or unacceptable toxicity.

      After completion of study treatment, patients are followed up periodically for up to 10
      years.