The 1st International Workshop on Acute Leukemias (iwAL), held in St. Pete Beach, FL, was a great success, with the experts in attendance expressing their surprise that this was the first such meeting. In this panel discussion, filmed at iwAL 2018, Alan Burnett, MD, FRCP, of Cardiff University, Cardiff, UK, is joined by Wolfgang Hiddemann, MD, PhD, from Ludwig-Maximilian University of Munich, Munich, Germany, Mark Levis, MD, PhD, of the Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, and Richard Stone, MD, of the Dana-Farber Cancer Institute, Boston, MA. The panel cover the advances presented at the meeting, focusing on the array of novel drugs now available for the treatment of acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Following the explosion of molecular data released, the experts contemplate where the field is moving. The discussion centers around the potential increase in the complexity of trial design. The panel also consider the need for next-generation sequencing and karyotyping.