Figure 3. Peripheral blood smears exhibit a predominance of blast cells, constituting approximately 90% of nucleated cells identified within the smears. The blast cells exhibit a range of sizes, primarily appearing small-to-intermediate in diameter, with prominent nuclei occupying a significant portion of the cellular area. Notably, the nuclei display immature chromatin patterns and irregular nuclear contours associated with a thin rim of cytoplasm. Within the blast population, there are multiple occasional small nucleoli. These cellular demonstrations are characteristic morphological features consistent with a diagnosis of B-cell acute lymphoblastic leukemia (B-ALL). Within the smears, normal hematopoietic elements are markedly decreased, and megakaryocytes are visible.