ALSG consensus on the role of hematopoietic stem cell transplantation Some ALSG members felt that the high chance of relapse within 3–4 years, even with consolidation therapy, may justify the use of ASCT in young, fit patients. While the recommendation that all responding patients should receive ASCT has become generally accepted, this remains uncertain, especially with novel agents such as the Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib changing the therapeutic landscape. Therefore, for young women of reproductive age, ASCT could be avoided and in relatively older individuals for whom reproduction is not a concern, ASCT remains an important option. In most countries in Asia, HSCT is reimbursed by payors whereas novel therapies are not. The decision for transplant versus alternative management strategies may be financially driven rather than data-driven. Real-world data may demonstrate the role or benefit of auto-SCT in some patients. Whether high-dose therapy followed by ASCT can be safely omitted from intensive first-line therapy that incorporates a BTK inhibitor will be tested in the European MCL Network TRIANGLE trial (NCT02858258).