Stem Cell Transplantation Compared With Standard Chemotherapy in Treating Patients With Acute Lymphoblastic Leukemia in First Remission

DISEASE CHARACTERISTICS:

* Histologically confirmed acute lymphoblastic leukemia (ALL)

  * More than 25% lymphoblasts in bone marrow

    * Patients with myeloid antigen expression AND unequivocal lymphoid immunophenotype are eligible
* Philadelphia (Ph) chromosome status determined by cytogenetics, fluorescence in situ hybridization (FISH), and/or RNA analysis

  * Patients determined to be Ph chromosome negative by cytogenetics, but positive for BCR-ABL by FISH or polymerase chain reaction are considered Ph chromosome positive
  * Patients with Ph chromosome-positive disease may be up to age 65
* No myelodysplasia or other antecedent hematologic disorder
* Patients age 50 and under must be HLA typed during induction therapy of study treatment OR provide a written explanation for not undergoing HLA typing

  * A and B typing required
  * C and DR typing done if feasible
* Allogeneic stem cell transplantation patients must meet the following criteria:

  * Appropriate HLA histocompatible donor available

    * Ph chromosome-negative patients must have HLA identical sibling
    * Ph chromosome-positive patients must have HLA identical, HLA-matched unrelated, or haploidentical related donor
* Postinduction therapy:

  * CSF negative for leukemia
  * No occult or overt leukemic meningitis
  * Documented complete remission

PATIENT CHARACTERISTICS:

Age:

* 15 to 65

Performance status:

* Induction therapy:

  * Not specified
* Postinduction therapy:

  * 0-1

Life expectancy:

* Not specified

Hematopoietic:

* See Disease Characteristics

Hepatic:

* Induction therapy:

  * Direct bilirubin ≤ 2.0 mg/dL
* Postinduction therapy:

  * Direct bilirubin \< 2.0 mg/dL
  * SGPT or SGOT \< 3 times normal

Renal:

* Induction therapy:

  * Creatinine \< 2 mg/dL
* Postinduction therapy:

  * Creatinine ≤ 2 mg/dL
  * Creatinine clearance ≥ 60 mL/min

Cardiovascular:

* Induction and postinduction therapy:

  * No significant cardiac disease requiring digoxin and/or diuretics
  * No major ventricular dysrhythmia requiring medication
  * No ischemic heart disease requiring medication
* Postinduction therapy:

  * Cardiac ejection fraction ≥ 50% for patients under consideration for transplantation

Pulmonary:

* Induction therapy:

  * Not specified
* Postinduction therapy:

  * FEV\_1 ≥ 60% of predicted for patients under consideration for transplantation
  * DLCO ≥ 50% of predicted for patients under consideration for transplantation

Other:

* Induction and postinduction therapy:

  * HIV negative
  * No concurrent organ damage or other medical problem (e.g., psychiatric disorder or drug abuse) that would preclude study therapy
  * Not pregnant
* Postinduction therapy:

  * No persistent infection

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* No concurrent umbilical cord allogeneic transplantation

Chemotherapy:

* Not specified

Endocrine therapy:

* Prior corticosteroids for ALL allowed

Radiotherapy:

* Not specified

Surgery:

* Not specified

Other:

* Induction and postinduction therapy:

  * No other prior therapy for ALL
* Postinduction therapy:

  * No concurrent antibiotics