Dr. Gopal Arora (Emergency Medicine) needs a second opinion on this medical case.
*Chief Complaint* A 54 y/o male, carrier of the β-thalassemia trait presented with anemia. *Vitals* BP:125/80 mmhg, Resp rate: 17 bpm, Pulse: 73 bpm, Temp: 98.6 degree F *Investigations* 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. *Treatment* How should we proceed further?
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