Dr. Gopal Arora (Emergency Medicine) needs a second opinion on this medical case.
A 54 y/o male, carrier of the β-thalassemia trait presented with anemia.
BP:125/80 mmhg, Resp rate: 17 bpm, Pulse: 73 bpm, Temp: 98.6 degree F
CBC shows pancytopenia, WBC: 3.4 × 103/μl, HB: 5.9 g/dl, MCV: 63.7 fl, platelets: 47 × 103/μl, neutrophils: 1.2 × 103 /μl and lymphocyte count 2.4 × 103/μl.
Peripheral smear shows microcytic hypochromic anemia & neutropenia. Bone marrow aspiration & biopsy shows hypercellular marrow with 95% of nucleated cells being blasts of lymphoid features.
Immunophenotyping diagnosed B-cell common acute lymphoblastic leukemia.
Karyotype was normal.
How should we proceed further?