Twenty-three patients admitted for treatment of refractory or relapsed acute leukemias (12 acute nonlymphocytic leukemias, 4 acute lymphocytic leukemias, 1 acute undifferentiated leukemia, 6 chronic myeloid leukemias in blast crisis) received a regimen employing a 4-day continuous intravenous infusion of epirubicin followed by a 4-day continuous infusion of vincristine. The remission rate (complete and partial) was 52%. This treatment was associated with minimal extrahematologic toxicity, particularly cardiac and gastrointestinal toxicity. This method of administration should be considered a reasonable therapeutic approach to pretreated acute leukemia patients, particularly in elderly patients wishing to avoid chemotherapy-related side effects.