During induction of Acute Lymphoblastic Leukaemia (ALL) cytopenias lead to frequent toxicities, treatment interruptions, and higher mortality rates. Blood count kinetics can also be potential markers of chemotherapy efficacy and bone marrow recovery. Understanding kinetics of blood counts and their association with clinical outcomes can help in optimizing weekly chemotherapy schedule according to risk of toxicity. 243 cases were analysed and baseline data, nadir, time to recovery of counts during induction, and survival outcomes were recorded. Median age was 15 (1-62) years. Immunophenotype was B-ALL in 71%, T-ALL in 27%. Good steroid response (D8) was seen in 89%, CR in 79%, and induction mortality in 12%. Median neutrophil nadir was 0.06(0-0.49) *10 9/L and median day to nadir was D17. Median time to partial and complete platelet recovery was D18 and D25. Late neutrophil nadir (>D15) was independent predictor of refractory disease [OR=5.43; p=0.042)], late partial platelet recovery (>D22) was independent predictor of poorer EFS and OS (HR = 1.63 [p = 0.020] and HR = 1.5 [p = 0.044]. Validation of blood count kinetics as independent predictors of post-induction and survival outcomes provides neutrophil and platelet counts as a simple, easy-to-use tool for balancing treatment efficacy-toxicity during induction.