The t-MDS/AML that they produce has a latency period of 1–5 years, usually does not present as a t-MDS but as an overt t-AML from the beginning and is often associated with balanced chromosomal translocation.16,17 The amount of cumulative dosage is equivocal and in the setting of the therapy of other hematological malignancies several regimen-related factors, as the schedule and concurrent use of asparaginase and G-SCF, are important in determining the relative risk.18,19 Especially etoposide has strictly been associated with translocations of the MLL gene on chromosome band 11q23. This evidence concerns the gene KMT2A and acute myeloid leukemia.