<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 4-year-old girl is brought to the physician because of a 3-week history of generalized fatigue and easy bruising. During the past week, she has also had fever and severe leg pain that wakes her up at night. Her temperature is 38.3C 100.9F, pulse is 120min, and respirations are 30min. Examination shows cervical and axillary lymphadenopathy. The abdomen is soft and nontender; the liver is palpated 3 cm below the right costal margin, and the spleen is palpated 2 cm below the left costal margin. Laboratory studies show:Hemoglobin 10.1 gdLLeukocyte count 63,000mm3Platelet count 27,000mm3A bone marrow aspirate predominantly shows immature cells that stain positive for CD10, CD19, and TdT. Which of the following is the most likely diagnosis?? A: Hodgkin lymphoma, B: Hairy cell leukemia, C: Aplastic anemia, D: Acute myeloid leukemia, E: Acute lymphoblastic leukemia,  <response>: Based on the information provided in the question stem, the key findings are:- 4-year-old girl with 3-week history of fatigue, easy bruising, fever, leg pain, lymphadenopathy, hepatosplenomegaly- Lab studies show anemia, high white blood cell count, low platelet count - Bone marrow aspirate shows immature cells positive for CD10, CD19 and TdTThis clinical presentation is most consistent with acute lymphoblastic leukemia ALL. The young age, fatigue, easy bruising, bone pain, enlarged liverspleen, abnormal blood counts and presence of lymphoblasts in the bone marrow are classic features of ALL. The other options can be ruled out:- Hodgkin lymphoma - unlikely with the bone marrow findings- Hairy cell leukemia - rare in children - Aplastic anemia - would not have high white blood cell count- Acute myeloid leukemia - blast cells would be negative for TdTE: Acute lymphoblastic leukemia 