الفهرس 
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Abstract
Introduction: Acute lymphoblastic leukemia (ALL) is a malignant transformation and proliferation of lymphoid progenitor cells in the bone marrow, blood and extramedullary sites. Compared to children, adolescents have high relapse rates and short survival ALL in adults may be managed in one of two approaches; BFM-like chemotherapy, and “hyper-CVAD” regimen. The latter approach consists of cycles composed of two courses (A and B) alternating with each other. Course A consists of cyclophosphamide and mesna, doxorubicin, vincristine and pulses of dexamethasone. Course B consists of intermediate-dose methotrexate (MTX) with leucovorin rescue, high-dose cytarabine and Methylprednisolone. For CNS prophylaxis, intrathecal MTX and cytarabine with cranial radiation Treating adults with pediatric protocols of high dose of non myelosuppressive medications, rather than the adult protocols, might improve their outcomes and increase the chance of continuous remission. The aim of work:-Rate of first CR (complete remission of each regimen).-Tolerability and toxicity of each regimen. Research Plan: This study is a retrospective and prospective study evaluating the efficacy ofthe two widely used regimens (Hyper-CVAD and BFM regimens) for treatment of adult Philadelphia negative acute lymphoblastic leukemia patients at Oncology Center Mansoura University Results : This study is a retrospective and prospective study evaluating the efficacy of the two widely used regimens (Hyper-CVAD and BFM regimens) for treatment of adult Philadelphia negative acute lymphoblastic leukemia patients at Oncology Center Mansoura University. BFM regimen was comparable to Hyper CVAD with trending to wards BFM in OS. Conclusion: The BFM protocol appears to be appropriate for young adult patients with ALL.