Inclusion Criteria:

          1. Able to understand and have the ability to provide written consent

          2. Age > 18 years old to <80 years old

          3. Patients with AML in the first morphologic relapse as defined by >5% reappearance of
             leukemia blasts in the bone marrow not attributable to any other cause (Appendix I)
             who have not yet received chemotherapy for the current relapse

          4. Eastern Cooperative Oncology Group Performance Status of 0 -2 (see Appendix II)

          5. Adequate organ function

               1. Serum creatinine ≤ 1.5 mg/dl and calculated creatinine clearance ≥ 50 mL/min
                  (using the Cockcroft-Gault equation CL creatinine = (140-age) x body mass X 0.85
                  if female)/72 x creatinine where age is given in years, body mass is given in kg
                  and creatinine is given in mg/dL)

               2. Aspartate aminotransferase (AST) ≤ 5x the upper limit of normal Alanine
                  aminotransferase (ALT) < 5x the upper limit of normal

               3. Direct bilirubin ≤ 1.5 mg/dl Note: As many eligible patients will be pancytopenic
                  secondary to their disease or prior treatments, hematologic abnormalities will
                  not be used as a criteria for entry or exclusion

          6. Left ventricular ejection fraction (LVEF) ≥50 %

          7. Females of child-bearing potential must have a negative pregnancy test during
             screening and all subjects must agree to use an effective method of contraception. A
             woman is eligible to enter and participate in the study if she is of:

               1. Non-childbearing potential (i.e., physiologically incapable of becoming pregnant)
                  including any female who has had a hysterectomy or has had a bilateral
                  oophorectomy (ovariectomy).

               2. Childbearing potential, has a negative serum pregnancy test during the screening
                  period and agrees to avoid sexual activity or use accepted methods of
                  contraception from screening through follow-up.

        Men with a female partner of childbearing potential are eligible to enroll and participate
        in the study if they have had either a prior vasectomy or agree to avoid sexual activity or
        use appropriate barrier contraception from screening through post-treatment follow-up.

        Exclusion Criteria:

          1. Acute promyelocytic leukemia

          2. Prior chemotherapy regimen given for 1st relapse, not including the use of hydroxyurea
             or plasmapheresis that is used prior to the initiation of chemotherapy.

          3. Previous use of mitoxantrone and etoposide combination therapy within the preceding
             180 days of screening.

          4. Symptomatic central nervous system (CNS) involvement

          5. Uncontrolled, life-threatening infection that is not responding to antimicrobial
             therapy

          6. History of psychiatric disorder which may compromise compliance with the protocol or
             which does not allow for appropriate informed consent

          7. Current receiving any other anti neoplastic investigational agents

          8. Prior autologous or allogeneic stem cell transplantation

          9. Concurrent malignancy. Exceptions: Patients who have been disease-free for 5 years, or
             subjects with a history of completely resected non-melanoma skin cancer or
             successfully treated in situ carcinoma are eligible. Subjects with concurrent
             malignancies that are indolent or definitely treated may be enrolled.

         10. Women who are pregnant or breastfeeding

         11. Evidence of severe or uncontrolled systemic disease (e.g., unstable or uncompensated
             respiratory or cardiac disease)

         12. Inability to take oral medications, due to impaired swallowing ability or poor
             absorption capacity

         13. Known glucose-6-phosphate dehydrogenase (G-6PD) deficiency