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Bone marrow (BM) stromal cells release cysteine for uptake by chronic lymphocytic leukemia (CLL) cells, driving anti-oxidative glutathione synthesis, which provides protection against ROS generating chemotherapeutic agents, such as fludarabine and oxiplatin.9 Mesenchymal stem cells (MSC) are key constituents of the BM microenvironment and have been shown to enhance protection against certain drugs in T-ALL cell lines10 and primary samples from patients with B-ALL, acute myeloid leukemia (AML) and CLL.13119 Co-culture of T-ALL cell lines with MSC enhanced resistance to the anthracycline idarubicin.10 However, the role of ROS in stromal cell mediated protection in childhood ALL has not been reported