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Autologous hematopoietic cell transplant (auto-HCT) is not beneficial for patients with mantle cell lymphoma (MCL) in first complete remission (CR) with undetectable minimal residual disease (uMRD), according to findings presented at the American Society of Hematology annual meeting. The researchers conducted a four-arm trial involving adults with MCL in first remission. Patients in CR with uMRD at 1 in 10-6 sensitivity were randomly assigned to arm A (auto-HCT plus three years of maintenance therapy) or arm B (three years of maintenance therapy alone). Patients with MRD-positive or MRD-indeterminate CR received auto-HCT plus three years of maintenance therapy (arms C and D, respectively). The estimated overall survival hazard ratios for arms A and B in all randomized (n=516) and treated-as-assigned patients (n=375) were 1.11 (95% CI, 0.71-1.74; P=0.66) and 1.00 (95% CI, 0.58-1.74; P=0.99), and crossed the boundary for futility. Three-year overall survival was 82.1% and 82.7%, respectively, for arms A and B in all randomly assigned patients and 86.2% and 84.8%, respectively, in those treated as assigned.