With the recent influx of targeted, highly effective novel agents to the field of acute lymphoblastic leukemia (ALL), there is some uncertainty surrounding the role of aggressive treatments like stem cell transplant. In this video, recorded at the American Society of Oncology (ASCO) 2018 Annual Meeting in Chicago, IL, David Maloney, MD, PhD, of the Fred Hutchinson Cancer Research Center, Seattle, WA, discusses the role of stem cell transplants in ALL. He explores data on the subject, and concludes that in adults there is still a definite use for stem cell transplants, particularly in the relapsed setting. He points out the importance of measurable residual disease (MRD) testing in informing treatment decisions surrounding stem cell transplants, as well as the utility of transplants in MRD negative remission following CAR T-cell therapy. Finally, he touches upon pediatric stem cell transplants, where the evidence is a lot more vague regarding transplant redundancy.