In the meantime, there have been changes in guidelines and treatment in both AYA and pediatric treatment—for example, the addition of PEGylated asparaginase (which has been shown to improve clinical outcomes and survival) instead of L-asparaginase (used before that time period) to the standard treatment regimen for AYA ALL patients, and the centralization of the pediatric oncology in the Princess Maxima Center for Pediatric Oncology in 2018. Here, ASPG is linked to acute lymphoblastic leukemia.