B-acute lymphoblastic leukemia (B-ALL) often grants with pancytopenia or bicytopenia, with thrombocytopenia being the most important parameter. The case of a 2-year-old child presented as a limp with bicytopenia on peripheral smear was presented. On bone marrow examination, 75% morphologically lymphoid blasts, block positive for periodic-acid Schiff on cytochemistry were found. The blasts suppressed the erythroid population but not the megakaryocytic population. On flow cytometry, a diagnosis was made as common-ALL-antigen positive B-precursor ALL. To conclude, a bone marrow aspirate is decisive in patients with bi/pancytopenia who present with a normal platelet count.
B-cell acute lymphocytic leukemia, Normal platelet count, Bicytopenia, Limping, Bone marrow biopsy