Sonia presented to Civil Hospital in Peshawar with complaints of high-grade fever in Dec 2017.Blood CP revealed Leukocytosis. Bone marrow examination revealed AML-Mo. She received two cycles of D3+A7 (insufficient doses) & four cycles of HIDAC at Peshawar in Jan 2018. Bone marrow showed morphological remission.  Her, last cycle was complicated with ARDS & was treated with IV antibiotics successfully. Sonia relapsed in April 2019 after 10 months of chemotherapy. Bone marrow examination then, revealed 75% blast cells. She was referred to AFBMTC for further management.

Sonia reported to AFBMTC in May 2019. She was admitted for salvage therapy with FLAG-Ida followed by allogenic bone marrow transplantation. She was fully HLA matched with her brother. Sonia received FLAG at AFBMTC and her post FLAG BME was in morphological remission.

At the time of transplant she was clinically stable with unremarkable physical examination.

Transplant was performed on Date of BMT: 28/08/2019 with BU^{12.8 IV} /CY¹²⁰/ATG¹⁰ used as conditioning protocol. Neutrophil engraftment was achieved on Day +13

Sonia experienced problems like febrile neutropenia, CSA toxicity, Transplant associated thrombotic microangiopathy, azotemia and PV bleed during her transplant period. Sonia had hyperbilirubinemia, raised LDH, azotemia, low platelet count and 4-5 schistocytes on peripheral blood film on day +13 so IV cyclosporine was reduced due to suspicion of CSA induced TMA and MMF was added on (Day +15). Her condition improved gradually with normalization of LDH, absence of schistocytes on peripheral blood film and she was maintaining hemoglobin without transfusion support.