A 31-year-old female was admitted to the neurosurgery department with fainting and headache. MRI of the brain revealed a mass in the left frontal lobe. She underwent a left frontal craniotomy and complete excision revealing a glioblastoma multiforme (GBM). Later, she was started on antiepileptic medication, phenytoin, and referred for adjuvant treatment. She started concomitant brain RT with TMZ, administered at 150 mg/m2 for 5 days every 4 weeks. After three cycles of adjuvant TMZ therapy, she was admitted to the medical oncology department with fever, and complete blood count showed pancytopenia with hemoglobin level 6.3 g/dL (13.6-17.2), platelet count 19,000/mm3 (156,000-373,000),  and total leucocyte count 100/mm3. TMZ was stopped. She was treated with blood products, growth factors, and antibiotics. Phenytoin was changed to carbamazepine. Her medical history revealed a fever continuing for 30 days with productive cough. Chest radiograph and CT scan revealed an infiltration at the superior segment of the left lower lobe with pleural effusion. Aspergillus sp. grew in bronchial washing and sputum cultures, cytology revealed no malignancy, and cultures were negative for tuberculosis. Forty days later, blood tests showed hemoglobin level 8.3 g/dL (13.6-17.2), platelet count 16,000/mm3 (156,000-373,000) and total leucocyte count: 50/mm3. Clinical and radiographic findings were not improved. Bone marrow aspiration and biopsy were subsequently performed. The biopsy was severely hypocellular with very few erythroid and myeloid cells at any stage of differentiation and hardly any identifiable progenitor cells, suggesting features of aplastic anemia (Figure 1). Cytogenetic analysis of marrow was not performed. She did not receive co-trimoxazole prophylaxis, and her vitamin B12 and folic acid levels were normal. The patient had a rapidly deteriorating course and died due to septicemia.