Acute megakaryocytic leukemia following chemotherapy for a malignant teratoma

A 20-year-old man underwent systemic chemotherapy (four cycles of vinblastine sulfate, bleomycin sulfate, and cisplatin) following full resection of a malignant mediastinal teratoma without evidence of metastatic spread. Five months following this resection, pancytopenia, circulating blast cells, and bone marrow necrosis developed. An autopsy disclosed a disseminated megakaryocytic neoplasm. Although a cause-effect relationship is suggested, the duration between the institution of therapy and the appearance of this megakaryocytic malignant neoplasm is less than the latent periods previously reported for cases of therapy-related leukemias. This case is also compared with other reports of therapy-related hematopoietic disorders with prominent megakaryocytic proliferations.