A patient with acute nonlymphoblastic leukemia in relapse and anthracycline cardiomyopathy was treated with AMSA in combination with cytosine arabinoside and thioguanine (AAT). Induction of remission was accomplished after one course of therapy without development of congestive heart failure. Radionuclide studies done prior to and subsequent to the reinduction with AAT revealed that the combination did not induce further deterioration of myocardial function. Although the exact risk of AMSA causing additional cardiac damage will require more extensive experience, this case suggests that AMSA may be safely given to patients with anthracycline cardiomyopathy and may be the treatment of choice for this group of patients.