A 37-year-old woman with Philadelphia chromosome-positive acute lymphoblastic leukemia received allogeneic bone marrow transplants after first and second relapses from different HLA-identical brothers. After a third relapse, blood progenitor cells from one of the brothers were infused after six doses of cytarabine 1.5 g/m2 in an attempt to induce a graft-versus-leukemia effect. Seven weeks after the infusion, the patient developed delayed but severe acute graft-versus-host disease (GVHD) including the unusual manifestation of conjunctival involvement.