
    business decision (no safety or efficacy concerns)
  
['precursor cell lymphoblastic leukemia-lymphoma']
['ixazomib']

        Inclusion Criteria:

          1. Diagnosis of relapsed/refractory ALL with or without extramedullary disease, including
             central nervous system (CNS)2 (<5 white blood cell [WBC]/mcL] in the cerebrospinal
             fluid [CSF] with blasts) and CNS3 (>=5 WBC/mcL in the CSF with blasts), or
             relapsed/refractory LLy. Participants with mixed-phenotype ALL or mature
             (Burkitt-like) leukemia are excluded.

          2. Relapsed/refractory ALL must have >=5% blasts in the bone marrow by morphology.

          3. Relapsed/refractory LLy participants must have measurable disease documented by
             clinical, radiologic, and histologic criteria.

          4. A Karnofsky performance status of >=50% (for participants aged >16 years) and a Lansky
             performance status of >=50% (for participants aged <=16 years).

          5. Adequate organ function.

          6. Failure of 1 or more therapeutic attempts.

          7. Full recovery from the acute toxic effects of all prior chemotherapy, immunotherapy,
             or radiotherapy before entering this study, as follows:

               -  Cytoreduction with hydroxyurea: Hydroxyurea can be initiated and continued for up
                  to 24 hours before the start of protocol therapy.

               -  Cytotoxic therapy: At least 14 days must have elapsed since the completion of the
                  last dose of chemotherapy, except intrathecal (IT) chemotherapy and/or
                  maintenance therapy, such as vincristine (VCR), mercaptopurine, methotrexate, or
                  glucocorticoids. There is no waiting period for those relapsing on maintenance
                  therapy.

               -  Hematopoietic stem cell transplantation (HSCT): Participants who have relapsed
                  after HSCT are eligible, provided they have no evidence of acute or chronic
                  graft-versus-host disease (GVHD), are not receiving GVHD prophylaxis or
                  treatment, and are at least 90 days posttransplant at the time of enrollment.

               -  Hematopoietic growth factors: At least 7 days must have elapsed since the
                  completion of therapy with granulocyte colony-stimulating factor (G-CSF) or other
                  growth factor at the time of enrollment. At least 14 days must have elapsed since
                  the completion of therapy with pegfilgrastim.

               -  Biologic (antineoplastic agent): At least 7 days must have elapsed since the last
                  dose of a biologic agent. For agents that have known adverse events (AEs)
                  occurring beyond 7 days after the end of administration, this period must be
                  extended beyond the time during which AE are known to occur. The duration of this
                  interval must be approved by the project clinician (or designee).

               -  Monoclonal antibodies: At least 3 half-lives must have elapsed after the last
                  dose of an administered monoclonal antibody.

               -  Immunotherapy: At least 30 days must have elapsed after the completion of any
                  type of immunotherapy (example, tumor vaccines, chimeric antigen receptor
                  T-cells).

               -  Photon radiotherapy (XRT): Craniospinal XRT is prohibited during protocol
                  therapy. No washout period is necessary for radiation given to any extramedullary
                  site other than the CNS; >=90 days must have elapsed if prior total body
                  irradiation or craniospinal XRT was given.

               -  Anthracyclines: Participants must have had a lifetime exposure of <400 mg/m^2 of
                  doxorubicin equivalents of anthracyclines.

               -  Proteasome inhibitors: Participants with a prior exposure to proteasome inhibitor
                  (PIs) (example, bortezomib, carfilzomib) are eligible as long as the participant
                  demonstrated at least a partial response to chemotherapy with a PI.

        Exclusion criteria:

          1. ALL participants: have isolated extramedullary disease, including CNS or testicular
             disease.

          2. Have Grade >=2 peripheral sensory or motor neuropathy, defined by the Modified "Balis"
             Pediatric Scale of Pediatric Neuropathies, at the time of enrollment.

          3. Have a planned administration of chemotherapy, radiation therapy, or immunotherapy,
             other than the study drugs used for this protocol.

          4. Have deoxyribonucleic acid fragility syndromes (example, Fanconi anemia, Bloom
             syndrome).

          5. Have Down syndrome.

          6. Are receiving cyclosporine, tacrolimus, or other agents to prevent graft-versus host
             disease (GVHD) after HSCT.

          7. Have Philadelphia chromosome (Ph)-positive ALL or Ph-like ALL and are currently
             receiving tyrosine kinase inhibitor therapy.

          8. Are receiving systemic treatment with strong inducers of cytochrome P450 3A
             (CYP3A)(example,rifampin, rifapentine, rifabutin, carbamazepine, phenytoin,
             phenobarbital, St. John's wort) within 14 days before study enrollment.

          9. Are receiving systemic treatment with strong CYP3A inhibitors within 14 days before
             study enrollment.

         10. Are receiving systemic treatment with inhibitors or inducers of P-glycoprotein (P-gp)
             within 14 days before study enrollment.
      