A 21-year-old man was diagnosed with T-cell lymphoid blast crisis with underlying chronic myeloid leukemia (CML) in May 2019. He was treated with a pediatric chemotherapy regimen plus tyrosine kinase inhibitor (TKI) and achieved major molecular remission after induction. He underwent haploidentical HCT in June 2020 with fludarabine/TBI MAC conditioning along with rabbit antithymocyte globulin (ATG) and post-transplant cyclophosphamide with CSA and Mycophenolate Mofetil (MMF) for GVHD prophylaxis. On day zero of transplant, his donor (father) tested positive for SARS-Cov2 by PCR. The collection was postponed for one day in an attempt to find another donor; in the meantime, the donor was given HCQ and azithromycin. All his other family members tested positive for SARS-Cov2 by PCR, and the decision was made to proceed with the initial donor apheresis. SARS-Cov2-PCR was negative on the apheresis product. The patient's SARS-Cov2-PCR was negative before admission and on day +1 after transplant. On day +5 post-HCT, the patient's SARS-Cov2-PCR from nasopharyngeal swab came back positive, but the patient was asymptomatic. He was treated with azithromycin and HCQ, and on day +10 post-HCT, one dose of tocilizumab was given secondary to elevated inflammatory markers (ferritin and interleukin 6). Platelet engrafted on day+9, while neutrophils engrafted on day+23. On day +12 post-HCT, SARS-Cov2-PCR from nasopharyngeal swab was repeated and was positive. On day +14, the post-HCT patient developed culture-negative neutropenic fever with further elevation in the inflammatory markers; the second dose of tocilizumab was given, and he was started on meropenem, but he was still asymptomatic besides fever, and specifically, he did not develop respiratory symptoms. On day+18, CT chest showed left lung ground-glass opacities. He then developed hemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS). He was treated with dexamethasone and Intravenous immune globulin (IVIG) for four days, and ruxolitinib was added due to a continuous rise in ferritin. After the addition of ruxolitinib, his inflammatory markers and liver enzymes decreased figure (1 and 2). Currently, he fully recovered and is asymptomatic; however, his repeat nasal SARS-Cov2 PCR on August 5, 2020, was definite, and his SARS-Cov2 total antibody test was non-reactive.