A 6-year-old male presents with recurrent epistaxis, easy bruising, and cervical lymphadenopathy. Complete blood count shows Hb 7.5 g/dL, WBC 45,000/uL with 65% lymphoblasts, and platelets 22,000/uL. What is the most common childhood malignancy diagnosed here?

Answer and explanation

Correct answer: A. Acute lymphoblastic leukemia (ALL)

  1. Step 1: Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood, accounting for approximately 75% to 80% of all pediatric leukemias, with peak incidence between 2 and 5 years of age.
  2. Step 2: Bone marrow infiltration causes pancytopenia (anemia, thrombocytopenia, neutropenia) and proliferation of lymphoblasts, presenting with pallor, petechiae, fever, and bone pain.
Answer
Acute lymphoblastic leukemia (ALL).
Why not the others: 'Acute myeloid leukemia (AML)' accounts for only 15% to 20% of pediatric leukemias; 'Neuroblastoma' is a solid tumor of the sympathetic nervous system presenting as an abdominal mass; 'Hodgkin lymphoma' is more common in adolescents.

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