Ewing's sarcoma is an uncommon yet vital malignancy of bone. It demonstrates a predilection for the pediatric and young adult population. Chemotherapy is considered an important treatment modality for Ewing's sarcoma. However, the development of therapy-related leukemia, especially acute myeloid leukemia following treatment, is attributed to the use of substances such as alkylating agents and topoisomerase inhibitors which are genotoxic. There is a very few studies elaborating on the incidence rates of such complications. So, our aim is to quantify the risk of developing acute myeloid leukemia in Ewing sarcoma patients and provide an updated evidence to the literature.

Inclusion Criteria:

• Patients diagnosed with Ewing sarcoma
• Latency exclusion period of 6 months
• Sequence 0 or 1

Exclusion Criteria:

• patients lacking age documentation or age reported only on death certificates or autopsies

Patients diagnosed with Ewing sarcoma between 2000 and 2021, followed up for more than 10 years after the initial diagnosis. Site record ICD-O-3/WHO 2008 restricted to bone and soft tissue; and histological type ICD-O-3 specified as Ewing sarcoma (9364)