Therefore, given the efficacy that we report here in this older and high‐risk population, the critical role of asparaginase and corticosteroids in improving survival of children and young adults with ALL, the ability to achieve therapeutic levels with lower doses of asparaginase and the poor outcomes of obese patients in the AYA population when full dose pediatric regimens are employed, we believe that there is still a strong rationale for prospective trials testing‐modified pediatric intensive regimens with dose reduced asparaginase in these high‐risk populations with ALL. Here, ASPG is linked to acute lymphoblastic leukemia.