Liposomal Cytarabine in the Treatment of Central Nervous System Resistant or Relapsed Acute Lymphoblastic Leukemia in Children

Inclusion Criteria: * Age \< 18 years * Diagnosis of acute lymphoblastic leukemia (ALL) * Central nervous system involvement with malignant cells present in cerebrospinal fluid * CNS involvement may be refractive to prior systemic therapy, a first recurrence after prior systemic and intrathecal therapy or a second recurrence * CNS involvement may be an isolated lesion or present with other sites of disease * ECOG performance status 0-2 * Life expectancy of at least 8 weeks * Absence of severe organ dysfunction * Informed consent Exclusion Criteria: * Eligibility for AIEOP studies of first recurrence of ALL,and receiving therapy in a center participating in the AIEOP studies * Concurrent treatment with experimental therapies * Severe neurologic toxicities from previous chemotherapy * Severe coagulopathy at time of recurrence * Sepsis * Intrathecal therapy within 1 week of planned study therapy * Total body or head and spine radiation within 8 weeks of enrolment * Bone marrow transplant within 8 weeks of start of study therapy.