A 46-year-old male patient with a past medical history of pulmonary tuberculosis and gastroesophageal reflux, was diagnosed with intermediate risk AML following bone marrow biopsy and flow cytometry in a local hospital in August 2019. He presented with leukocytosis, anemia, malaise, fever and excessive sweating complaints. No numerical structural anomalies were detected in the chromosomal analysis, and at the same time no prognostic and therapeutically significant variant was detected in the next-generation sequencing panel. He commenced first line therapy with 7 + 3 induction chemotherapy regimen (cytarabine continuous infusion for 7 days plus idarubicine for 3 days). Bone marrow biopsy results after induction therapy revealed less than 5% residual blast count. He received two cycles of high-dose cytarabine as consolidation therapy. His second consolidation chemotherapy course was complicated with acute appendicitis and he underwent an emergency appendectomy operation. He had two matched sibling donors and he was referred to our center for allo-HSCT. Following the conditioning regimen with fludarabine and busulfan the patient underwent allo-HSCT in December 2019 from a full matched sibling donor. GVHD prophylaxis consisted of methotrexate and cyclosporine. The patient's neutrophils and platelets were engrafted on +12 and +17 days respectively. Peripheral blood chimerism on day +90 post-transplant demonstrated a successful engraftment, with 99% donor cells, and a bone marrow biopsy showed complete remission (CR). On day +98 skin biopsy was performed on his neck and was reported compatible with a grade 2 GVHD, which was treated with prednisone, cyclosporin and photopheresis. On day +120 he was admitted to hospital because of a CMV DNA positivity for which he got treated with ganciclovir. He was followed up in CR for 2 years, but he was admitted to the hospital with anemia and severe thrombocytopenia (28 x 10^3/ul) in December 2021. Bone marrow biopsy performed and demonstrated morphological CR with minimal residual disease (MRD) negativity by flow cytometry and biopsy, donor chimerism in the bone marrow was at% 99, unfortunately reported to be consistent with non-destructive PTLD. In situ hybridization showed that the PTLD was EBV-negative. His EBV deoxyribonucleic acid polymerase chain reaction results were negative. Of note, serum EBV viral capsid antigen-Immunoglobulin G (VCA-IgG) was positive in the recipient and donor in the pre-transplant period. PET-CT showed no abnormalities. For PTLD, he was treated with rituximab administered once a week for 4 weeks at a dosage of 375 mg/m2 and eltrombopag was given for severe thrombocytopenia. He responded well to the therapies; bone marrow biopsy performed in the 3rd month of rituximab treatment confirmed a CR. Eltrombopag was continued. The patient is still on his regular follow-ups with full hematological response and has shown no relapse thus far.