Klaus Metzeler, MD, from the University Hospital Grosshadern, Ludwig-Maximilians-University (LMU), Munich, Germany, discusses the clinical implications of persisting preleukemic clones in remission in acute myeloid leukemia (AML) at the International Symposium on Acute Leukemias (ISAL) 2017 in Munich, Germany. He explains that the detection of residual disease in the form of preleukemic clones is an evolving topic which may have strong prognostic implications, and that there is intense discussion on how patients should be managed. Dr Metzeler argues that biobanking should be standard to allow evaluation and validation of these markers. It is not yet certain whether clinical decisions should be based on the detection of preleukemic clones, however patients should be closely monitored, and additional markers of residual disease, such as NPM1 mutations, should also be assessed. By monitoring patients with persisting preleukemic clones closely, relapses will be detected quickly and patients can be treated early.