The first time chemotherapy for leukemia is not effective, the treatment plan should be adjusted according to the individual’s own situation and the degree of illness, and a bone marrow transplant can be used if necessary. Physical insensitivity to chemotherapy drugs or aggravation of the disease can cause poor chemotherapy results. Each patient has a different degree of tolerance to leukemia chemotherapy drugs due to differences in age, underlying diseases, and physical fitness, resulting in different efficacy of chemotherapy. Similarly, differences in efficacy can occur with different types of leukemia and different degrees of disease. Specific chemotherapeutic drugs include cytarabine and flexerodine. When the effect of the first chemotherapy is not good, the treatment plan that is not cross-resistant to each other can be chosen to reduce drug resistance, such as acute myeloid leukemia combined with the use of azacitidine, vinpocetine and other demethylating drugs and targeted drugs to enhance the efficacy of the treatment, and can also be changed by changing the route and method of drug delivery, so as to make the local concentration of the drug increase and improve the efficacy of the treatment. If necessary, bone marrow transplantation can be considered to control the disease. When the effect of the first chemotherapy for leukemia is not good, relevant examinations can be carried out under the guidance of the doctor, and the treatment plan can be adjusted for standardized treatment.