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Background and aim: Only 20–30% of elderly patients with acute lymphoblastic leukemia (ALL) are enrolled in clinical trials because of co‐morbid disorders or poor performance status. We present the results of treatment of Philadelphia chromosome‐negative (Ph−) ALL patients over 55 yr treated in the PETHEMA ALL‐96 trial. Patients and methods: From 1996 to 2006, 33 patients 55 yr with Ph− ALL were included. Induction therapy was vincristine, daunorubicin, prednisone, asparaginase, and cyclophosphamide over 5 weeks. Central nervous system (CNS) prophylaxis involved triple intrathecal (IT) therapy, 14 doses over the first year. Consolidation‐1 included mercaptopurine, methotrexate, teniposide and cytarabine, followed by one consolidation‐2 cycle similar to the induction cycle. Maintenance consisted of mercaptopurine and methotrexate up to 2 yr in complete remission (CR) with monthly …