By means of a mail questionnaire, we evaluated the influence of treatment for acute leukemia on offspring of long-term survivors and determined whether pregnancy in patients (or spouses) induced relapse of acute leukemia. In 322 replies from the 445 institutions where a questionnaire was sent, there were 1,136 adult long-term survivors. We analyzed 43 adults who had become pregnant or a father after postremission therapy. The mean age at leukemia onset was 26.4 and 21.6 years for males and females, respectively. Forty-six normal children (26 boys and 20 girls) were born to long-term survivors including 7 pairs of siblings and a pair of twin sisters. There were no malformed babies. The average duration until delivery was 79 months after diagnosis and 49 months after the final postremission therapy. Four of 38 parents of live offspring died (3 relapse, 1 other disease), and the other 34 parents of live offspring were in complete remission at the point of this survey. The literature since 1986 (except case report) was reviewed for the current situation of pregnancy outcome in long-term survivors after chemotherapy for adult acute leukemia, malignant lymphoma and breast cancer.