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Acute nonlymphoblastic leukaemia is primarily a disease of the elderly. Current opinion is that intensive chemotherapy regimens are appropriate in elderly patients with this condition. However, there is still some controversy and only about 50% of patients receive this type of treatment.Mitoxantrone is effective as induction and salvage therapy in elderly patients with relapsed or refractory disease. Moreover, it compares favourably with standard agents such as daunorubicin.The tolerability profile of mitoxantrone appears to be similar to that of other chemotherapeutic agents. The drug may produce less cardiotoxicity than conventional agents (such as doxorubicin), but this has not been conclusively demonstrated in patients with ANLL.