ALL is a heterogeneous disease, and outcomes vary by patient age, immunophenotype and clinical, cytogenetic and molecular features. Modern treatment strategies use a risk-adapted approach. The optimal post-remission therapy for adults with ALL remains unclear. Available data indicate no consensus as to whether there is an advantage to allogeneic hematopoietic cell transplant (Allo-HCT) over chemotherapy for the consolidation of adults with ALL with standard risk features while in the first CR (CR1). However, Allo-HCT is recommended in CR1 for patients with high-risk ALL, for those in a second CR (CR2) and for certain other subsets of patients with this disease.