Examples include Liposomal vincristine (a vinca alkaloid): For adults with Ph - ALL in at least 2nd relapse or that has progressed despite ≥ 2 antileukemia therapy—marketing has been discontinued Clofarabine (a purine nucleoside analog): For patients age 1 to 21 years with relapsed or refractory ALL after ≥ 2 prior regimens Nelarabine (a purine nucleoside) analog prodrug of guanosine arabinoside: For T-cell ALL that has not responded to or has relapsed after ≥ 2 prior regimens Stem cell transplantation following reinduction chemotherapy or immunotherapy offers the greatest hope of long-term remission or cure if an HLA-matched sibling is available.