The number of cases of therapy-related acute myelogenous leukemia and myelodysplastic syndromes has risen with the advances of successful combination chemotherapy. Unfortunately, the therapy-related diseases are difficult to treat. Aggressive induction chemotherapy can induce a complete remission, but the remission duration is short. Differentiating agents, hormonal agents, and growth factors have all been disappointing. Allogeneic bone marrow transplantation remains the only curative approach.