Abstract:【Abstract】 Objective To investigate the efficacy and safety of middose cytarabine combined with mitoxantrone and etoposide in the treatment of refractory recurrent acute myeloid leukemia (AML).Methods 96 refractory recurrent AML patients from December 2008 to December 2012 in our hospital were selected as the study subjects. The clinical and followup data of all patients were analyzed by retrospective analysis. All the patients were given cytarabine mitoxantrone and etoposide consolidation treatment. However, according to the different doses of cytarabine, they were divided into low dose group, medium dose group, high dose group, each 32 cases. After the treatment, the clinical efficacy of the three groups of patients was analyzed and compared in the short and long term, and record the two groups of patients in the course of treatment of adverse reactions. Results The total recent clinical total efficiency of the three groups were not different. 8 of the patients with partial remission were cured after bone marrow transplantation, and the remaining 42 patients continued to be treated with drugs. The difference of 5year OS was statistically significant between the three groups (P<0.05). The 5year OS of middledose group and highdose group were higher than that of lowdose group, but middledose and highdose group. There was no difference in 5year OS. There was no difference in 5year EFS between the three groups (P>0.05). There were no differences in the adverse reactions of myelosuppression and cardiotoxicity between the three groups (P>0.05). However, the incidence of infection, gastrointestinal reaction and liver and renal dysfunction were significantly higher in the middledose group and the highdose group than in the lowdose group. The incidence of gastrointestinal tract injury and liver and kidney dysfunction in highdose group were higher than those in middledose group, with statistical significance (P<0.05).Conclusion The combination of middle dose of cytarabine and mitoxantrone and etoposide can improve the clinical curative effect and reduce toxicity of refractory recurrent AML. This method deserves to be the first choice of treatment for AML in clinic.