This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Childhood tumors, Subject name: Pediatrics
Increased fetal hemoglobin is seen in 
Select and explain. 
A. Juvenile CML, B. Congenital red cell aplasia, C. Hereditary shperocytosis, D. AML
A: Juvenile CML
Answer: A: Juvenile CML 
Explanation: Juvenile chronic myeloid leukemia is characterised by elevated fetal hemoglobin levels and low or normal leukocyte alkaline phosphatase score.Thrombocytopenia and anemia are common.Peripheral smear shows leukocytosis with the full spectrum of granulocytic precursors and increased normoblasts.Bone marrow aspirate shows an increased cellularity with predominance of granulocytic cells in all stages of maturation;megakaryocytes are normal or decreased.Philadelphia chromosome is negative,and monosomy 7 is found in 30% patients. Reference:Essential pediatrics-Ghai,8th edition,page no:608.