Pediatricians at Ochsner Clinic and Alton Ochsner Medical Foundation have treated children with acute lymphoblastic leukemia for the past 17 years with excellent results. Although a single institution, and small in comparison to the national cooperative groups, we have achieved results comparable to the most successful national groups. In collaboration with the Dana-Farber Cancer Institute in Boston, MA, we have pursued several themes of study, including the comparison of various drugs, doses, and schedules of administration in the context of an investigational window in previously untreated patients. Schedules and dosages of radiation for prevention of relapse of leukemia in the central nervous system have also been studied with interesting results.