A large prospective pooled dataset presented at ASH found that multiparameter flow cytometry–based minimal residual disease (MRD) before consolidation correlates with longer overall survival in acute myeloid leukemia (AML) and may serve as an intermediate surrogate endpoint. Jesse Tettero of the Fralin Biomedical Research Institute at Virginia Tech led the analysis, which the authors framed as the largest prospective MRD dataset in AML to date. Investigators argued the findings could justify use of MRD to accelerate AML drug development via the FDA’s accelerated approval pathway, while acknowledging overall survival remains the regulatory gold standard. Sponsors and regulators will need further prospective validation and standardized assays to adopt MRD routinely as a surrogate in registration trials.