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• This ESMO Clinical Practice Guideline update provides key recommendations for managing acute lymphoblastic leukaemia. • The update covers recent developments in the use of targeted therapies. • Algorithms for the management of newly diagnosed and relapsed or refractory disease are provided. • The author group encompasses a multidisciplinary group of experts from different institutions in Europe. • Recommendations are based on available scientific data and the authors' collective expert opinion. [ABSTRACT FROM AUTHOR]