ALSG consensus for indolent MCL Adoption of a management strategy similar to CLL, utilizing a “watch-and-wait” approach, may be appropriate for asymptomatic patients with MCL. Typical clinical presentation of indolent disease comprises leukemic non-nodal CLL-like, including splenomegaly, low tumor burden, and Ki-67 proliferation fraction < 10%; it is useful to confirm SOX11 negativity with hypermutated IGHV to determine clearly indolent disease. Notably, patients may be reluctant to undertake a watch-and-wait strategy. For asymptomatic patients desiring treatment, the same treatment scheme for symptomatic patients requiring treatment is considered. Communication between the clinician and the patient, as well as caregivers, in the decision-making process is recommended. Clinical trial enrollment is strongly suggested where possible.