title: Hematologic malignancies associated with primary mediastinal germ-cell tumors.
abstract: Three men with primary mediastinal germ-cell tumors subsequently developed a malignant hematologic disorder characterized by pancytopenia and marrow infiltration with hematopoietic blast cells. Two of these patients were classified as having acute megakaryocytic leukemia and the third was believed to have a myelodysplastic syndrome with a prominent megakaryocytic component. Analysis of clinical characteristics of these patients and review of the literature suggest that the proximate association of mediastinal germ-cell tumors with malignant hematologic disorders is neither a coincidence nor a consequence of chemotherapy given for the germ-cell tumor. We believe this association represents the evolution of a neoplastic disorder that initially involves a totipotent germ cell. These germ cells, when located in the mediastinum, apparently acquire hematologic phenotypes and are manifested clinically as a hematologic malignancy.
authors.forename: C R
authors.initials: CR
authors.lastname: Nichols
authors.forename: R
authors.initials: R
authors.lastname: Hoffman
authors.forename: L H
authors.initials: LH
authors.lastname: Einhorn
authors.forename: S D
authors.initials: SD
authors.lastname: Williams
authors.forename: L A
authors.initials: LA
authors.lastname: Wheeler
authors.forename: M B
authors.initials: MB
authors.lastname: Garnick
mesh_terms: D000208:Acute Disease; D000328:Adult; D001855:Bone Marrow Diseases / Q000473:pathology; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007938:Leukemia / Q000473:pathology; D007945:Leukemia, Lymphoid / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000097:blood* / Q000188:drug therapy; D009196:Myeloproliferative Disorders / Q000473:pathology; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood* / Q000188:drug therapy; D009378:Neoplasms, Multiple Primary / Q000473:pathology; D013736:Testicular Neoplasms / Q000097:blood; D013920:Thrombocythemia, Essential / Q000473:pathology
chemical_list: D002945:Cisplatin