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ALL (also called Acute Lymphocytic Leukemia) is an aggressive type of leukemia characterized by the accumulation of lymphoblasts in the marrow or in various extramedullary sites, frequently accompanied by suppression of normal hematopoiesis. It can spread to the lymph nodes, spleen, liver, central nervous system (CNS), and other organs. Without treatment, ALL usually progresses quickly. Patients with ALL may present with a variety of hematologic derangements ranging from pancytopenia to hyperleukocytosis. L3 (Burkitt’s) acute lymphoblastic leukemia (ALL) is characterized by blasts with cytoplasmic vacuolizations and surface expression of immunoglobulins. The bone marrow often has an appearance described as a starry sky owing to the presence of numerous apoptotic cells. (Source -NIH, National Cancer Institute). We express our sincere gratitude to Dr. Deepthi P Kambi for her participation and support in this.