Inclusion Criteria:

   - >= 15 and < 40 years at time of diagnosis

   - Newly diagnosed B-ALL, T-ALL, lymphoblastic lymphoma (LLy), or mixed-phenotype acute
   leukemia/lymphoma (MPAL)

      - Note: Philadelphia chromosome (PH)+ and PH-like acute leukemia are eligible (use
      of tyrosine kinase inhibitors [TKI] or CRLF2- targeted concomitant medication
      must be documented, if used)

   - Conjugated bilirubin =< 1.5 x upper limit of normal (ULN) for age, regardless of
   baseline bilirubin (within 7 days prior to enrollment), and

   - Serum glutamate pyruvate transaminase (SGPT) (ALT) =< 225 U/L (=< 5x ULN) (within 7
   days prior to enrollment), and

      - Note: For the purpose of this study, the ULN for SGPT (ALT) has been set to the
      value of 45 U/L and serum glutamic oxaloacetic transaminase (SGOT) (AST) to 50
      U/L regardless of baseline

   - SGOT (AST) =< 250 U/L (=< 5x ULN) (within 7 days prior to enrollment)

      - Note: For the purpose of this study, the ULN for SGPT (ALT) has been set to the
      value of 45 U/L and SGOT (AST) to 50 U/L regardless of baseline

   - Berlin-Frankfurt-Munich (BFM), Children's Oncology Group (COG), or C10403-based
   Induction regimen and must be inclusive of >= 1 dose of pegaspargase or calaspargase
   pegol, and

   - First dose of asparaginase must be planned within the first week of induction therapy,
   and

   - Dose of pegaspargase or calaspargase pegol must be >= 1,000 IU/ m^2 (dose-capping
   permitted per primary regimen)

      - Note: Co-enrollment on a therapeutic consortia trial is not required

   - All patients and/or their parents or legal guardians must sign a written informed
   consent

   - All institutional, Food and Drug Administration (FDA), and National Cancer Institute
   (NCI) requirements for human studies must be met

Exclusion Criteria:

   - Down syndrome

   - Known inherited or autoimmune liver disease impacting conjugated bilirubin (e.g.,
   Alagille syndrome, primary sclerosing cholangitis, other)

   - Known biopsy (or imaging) proven severe liver fibrosis (Batts-Ludwig >= stage 3)

   - Patients who received chemotherapy or treatment for a prior malignancy are not
   eligible

      - The following are permitted: steroid prophase, hydroxyurea, or other
      cytoreduction prior to initiation of Induction chemotherapy (must be documented)
      and chemotherapy for current diagnosis (i.e. initiation of Induction therapy
      within enrollment window). Chemotherapy prior to enrollment for treatment of a
      non-malignancy (e.g., steroid or methotrexate for autoimmune disease) is also
      permitted and must be documented

   - Female patients who are pregnant since fetal toxicities and teratogenic effects in
   humans are unknown for study drug. A pregnancy test is required for female patients of
   childbearing potential

   - Lactating females who plan to breastfeed their infants

   - Sexually active patients of reproductive potential who have not agreed to use an
   effective contraceptive method for the duration of their study participation