Inclusion Criteria:

* Patients must be enrolled on AALL03B1 prior to enrollment on AALL0331
* Initial white blood cells (WBC) < 50,000/ul
* Newly diagnosed B-precursor acute lymphoblastic leukemia

* Standard-risk (SR) disease meeting 1 of the following criteria:
* SR-average by age and WBC
* No unfavorable features
* Rapid early responder (RER) by day 15
* CNS 1 or 2
* Minimal residual disease (MRD) negative on day 29
* Trisomies of 4, 10, and 17 or TEL-AML1 translocation and RER and CNS2 allowed
* SR-low by age and WBC
* No unfavorable features
* RER by day 15
* MRD negative on day 29
* CNS1
* Favorable cytogenetics-trisomies of 4, 10, and 17 or TEL-AML translocation
* SR-high
* Unfavorable features meeting ≥ 1 of the following criteria:

* MLL rearrangements and RER
* Steroid pretreatment
* CNS3
* Slow early responder by morphology or MRD
* Patients with Down syndrome are allowed
* Patients with overt testicular disease are not eligible for this study, but may be eligible for AALL0232
* Patients shall have had no prior cytotoxic chemotherapy with the exception of steroids and intrathecal cytarabine; intrathecal chemotherapy with cytarabine is allowed prior to registration for patient convenience; this is usually done at the time of the diagnostic bone marrow or venous line placement to avoid a second lumbar puncture; (Note: the central nervous system \[CNS\] status must be determined based on a sample obtained prior to administration of any systemic or intrathecal chemotherapy, except for steroid pretreatment
* Patients receiving prior steroid therapy may be eligible for AALL0331 study
* Patients with a contraindication to additional asparaginase therapy, following Induction, are not eligible for the Standard Risk-Low study, and should be removed from protocol therapy at the end of Induction
* Patients who are assigned to the standard risk-average group following Induction and who meet the HRQOL
* Age at diagnosis >= 2 years (note that this is a more restrictive age range than for the therapeutic component of the study)
* At least one parent with reading comprehension of English or Spanish languages for which validated surveys exist
* Diagnosis at one of the institutions participating in this limited institution correlative study
* A parent or legal guardian must sign a written informed consent/parental permission for all patients
* All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met