An aged patient with acute leukemia, who has survived more than five years in complete remission, is reported. The patient was diagnosed as acute myelomonocytic leukemia at the age of 69. On admission, the proliferation of leukemic cells was remarkable in his peripheral blood and bone marrow. He had high fever, anemia and bleeding tendency due to thrombocytopenia. Complete remission was achieved within two months by initial combination chemotherapy (Predonine, Ara-C, Vincristine). Following the initial therapy, second combination chemotherapy, Daunomycin, Ara-C and Predonine, was performed. Shortly after the maintenance therapy of 6-MP, the signs of toxic hepatitis appeared. Without maintenance therapy for more than 4 years, he has survived 5.2 years and there has been no relapse.
Generally, intensive combination chemotherapy is not very efficacious on an aged patient with acute leukemia. However, this patient responded to relatively intensive chemotherapy very well. Among the prognostic facters, response of leukemic cells to chemotherapy seemed to be most significant in the survival of the present case.