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We describe the case of a patient suffering from acute myeloid leukemia and undergoing bone marrow transplant from MUD donor. At day +50 from the infusion of stem cells, active replication of the Epstein Barr virus is found, with exponentially increasing and reaching 66000 gEq/mL. Simultaneously, steroid therapy for gastrointestinal GVHD was initiated. The improvement was momentary, the viral replication increasing again soon after up to 113800 gEq/mL, with important deterioration of clinical conditions. Therapy with rituximab (Ab anti-CD20) was started weekly, with immediate reduction of viral replication (11800 gEq/mL) already after the first infusion, accompanied by improvement of the clinical conditions (figure A). Reactivation from EBV is a relatively frequent complication in patients undergoing bone marrow transplant, with high mortality and morbidity. Prompt diagnosis and rapid adequate treatment are essential for correct patient management, guaranteeing a good hope of survival.