Acute lymphoblastic leukemia (ALL) is a malignant disease of lymphatic cells in the bone marrow or other organs of the lymphoid system with a number of unique features. Cure rates were improved in the past decades first in children and later in adults from less than 10% to 40-50% and even >50% in distinct subgroups. Important progress was also achieved in basic research, particularly in molecular genetics. The progress in terms of diagnosis and treatment of ALL has stemmed mainly from systematic clinical research by a number of cooperative study groups. It is based on optimisation of chemotherapy, stem cell transplantation, supportive care integrated in risk adapted treatment strategies and more recently complemented by approaches for targeted therapy. The book gives an overview on the current strategies for ma-nagement of adult ALL including approaches to rare entities and specific situations. It represents the result of a structured consensus process conducted by the members of the European Working Group for Adult ALL.