Josep-Maria Ribera, MD, PhD from the Germans Trias i Pujol University Hospital, Barcelona, Spain, presents preliminary data, which shows that adult patients with high risk (HR) acute lymphoblastic leukemia (ALL) with an adequate minimal residual disease (MRD) response, can be safely managed without allogeneic hematopoietic stem cell transplantation (alloHSCT). He further explains why avoiding alloHSCT can be of advantage to the patients. The preliminary results are from the Pethema ALL-HR-11 trial presented at the American Society of Hematology (ASH) 2015 Annual Meeting, held in Orlando, FL.