Abstract: Objective: To study the cause of death for the patients with acute leukemia (AL) with survival time of over 5 years. Methods: The serial retrospective study was adopted to analyze the age of onset, sex, course of disease before chemotherapy, type of disease, case history, clinical manifestation, blood routine, myelogram, complications, minimal residual disease (MRD), tests for chromosomal abnormalities, induction plans, CR time, time of recurrence, direct cause of death, etc. for 17 cases of AL with survival times of over 5 years. Results: The factors affecting recurrence were as follows: acute lymphoblastic leukemia (ALL), male, exorbitant WBC, insufficient chemotherapy, and extramedullary leukemia. The cases with recurrence that stopped treatment early had systemic infiltration, resulting in death with multiple organ failure, or they died after hemorrhage and infection with post-chemotherapeutic myelosuppression. Conclusion: Long-term treatment with normalization and individualization for patients with AL should be developed. Regular monitoring after drug withdrawal is needed to prevent relapse. Stem cells transplants serve as a basic cure for AL.