ABSTRACT Introduction: Acute lymphoblastic leukemia (ALL) presents a poor prognosis in adults. The adoption of pediatric protocols has been changing this scenario, especially for adolescents and young adults (AYA). Objective and method: We aimed to evaluate a consecutive series of patients treated at the State Institute of Hematology of Rio de Janeiro between 2012 and 2020, focusing on the AYA subgroup. Result: The B-ALL was the most frequent subtype (81.6%) and AYA, the predominant age group (57.7%). The median overall survival (OS) was 9.4 months. High early mortality was observed and sepsis was the main cause of death. Better OS results were noted in AYA, in comparison to over 39y (13.3 × 6.2 months, respectively), the Berlin-Frankfurt-Münster (BFM) being the protocol of choice in this group. Conclusion: The use of the pediatric protocol seems to improve the OS of AYA, however, high rates of deaths from infection were observed, demonstrating the need for advances in the Brazilian public system clinical support. Introduction ALL (ALL scenario AYA. . (AYA) method 201 2020 subgroup Result BALL B 81.6% 816 81 6 (81.6% 57.7%. 577 57.7% 57 7 (57.7%) (OS 94 9 4 9. months death y 13.3 133 13 3 (13. 62 2 6. respectively, respectively , respectively) BerlinFrankfurtMünster Berlin Frankfurt Münster BFM (BFM Conclusion however support (AYA 20 202 81.6 8 (81.6 57.7 5 (57.7% 13. 1 (13 81. (81. 57. (57.7 (1 (81 (57. ( (8 (57 (5