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Objective: In childhood cancers, parents are affected psychologically as well as children. We aimed to evaluate the effect of childhood cancer type and stage, as well as elapsed time from diagnosis, on the anxiety and stress indicators among parents. Materials and Methods: Patients aged between 0–18 years and diagnosed with cancer who were receiving chemotherapy (0–1 month, 1–6 month, 6–12 month) and completed treatment were included. Parents of those children (mother or father) who agreed to participate this study were also included. The personal information form and three psychological assessment scales (Beck Hopelessness Scale (PSS), Psychological Resilience Scale (PRS), Uncertainty Intolerance Scale (IUS)) were used for assessment of mental health of the parents. Scores of the scales and clinical features of the children with cancer were compared statistically. Results: The study included 84 parents (57 mothers, 27 fathers) and 84 children. The rate of children with solid tumors was 60% (n:50) and 40% of them were metastatic, which means advanced stage. The rate of the children with leukemia was 40% (n:34) and 23% of them were in high-risk group. According to the type (leukemia vs. solid tumors) and stage (high risk/advanced stage vs. others) of the cancer, there was no statistical difference among parents in the psychological scales (p > 0.05). Additionally, results of the psychological scales showed no significant difference between mothers and fathers (p > 0.05). The hopelessness scores are significantly higher among parents whose child’s treatment is terminated compared with those whose active therapy is ongoing, and resilience scores are higher among parents who have less than 1 month since diagnosis of childhood cancer than later periods. Conclusions: The regular assessment of mental health among parents of children with cancer across all the survivorship trajectory: at the time of diagnosis, during active therapy, and after treatment.

Background. The aim of the study was to evaluate the approaches of pediatric rheumatologists and pediatric hematologists to patients with similar musculoskeletal (MSK) complaints and to highlight the differences that general pediatricians should consider when referring patients to these specialties. Methods. This is a cross-sectional study involving the patients who applied to pediatric rheumatology centers with MSK complaints and were diagnosed with malignancy, as well as patients who were followed up in pediatric hematology centers with a malignancy diagnosis, and had MSK complaints at the time of admission. Results. A total of 142 patients were enrolled in the study. Of these patients, 83 (58.4%) applied to pediatric rheumatology centers, and 59 (41.6%) applied to pediatric hematology centers. Acute lymphoblastic leukemia (ALL) was the most common diagnosis among the patients who applied to both centers, with 80 cases (56.3%). The median age of diagnosis was 87 (interquartile range, IQR: 48-140) months. The most common preliminary diagnosis in pediatric rheumatology centers was juvenile idiopathic arthritis (JIA), with 37 cases (44.5%). MSK involvement was mainly seen as arthralgia, and bone pain. While arthralgia (92.7%) was the most common complaint in rheumatology centers, bone pain (88.1%) was more common in hematology centers. The most frequently involved joints were the knee (62.9%), ankle (25.9%), hip (25%), and wrist (14%). The most common laboratory abnormalities were high lactate dehydrogenase (LDH), high C-reactive protein (CRP), anemia, and high erythrocyte sedimentation rate (ESR). Thrombocytopenia, neutropenia, and high LDH were statistically significantly more frequent in patients admitted to hematology centers than in patients admitted to rheumatology centers (p<0.001, p=0.014, p=0.028, respectively). Patients who applied to rheumatology clinics were found to have statistically significantly higher CRP levels (p=0.032). Conclusions. Malignancies may present with only MSK system complaints in childhood. Therefore, malignancies should be included in the differential diagnosis of patients presenting with MSK complaints.

Background/Objectives: Vitamin B12 and folic acid (FA) are crucial for children’s hematopoiesis after hematopoietic stem cell transplantation (HSCT). This study evaluates the B12 and FA level changes before and after HSCT. Methods: We retrospectively collected data from 125 patients who underwent HSCT between March 2019 and February 2024. B12 and FA levels were measured at three time points: before transplantation, one month after, and six months after. Sixty-two patients had complete data. B12 deficiency was defined as levels < 200 pg/mL and insufficiency as 200–300 pg/mL. Folate deficiency was classified as insufficiency ≤ 3 ng/mL, indeterminate for 4.0–5.8 ng/mL and typical for 5.9–26.8 ng/mL. Patients with B12 < 300 pg/mL and folic acid < 5 ng/mL were treated at all stages. Results: Among the 62 patients, 24 (38.7%) were girls, with a median age of 4 years (1.75–8.25). Median B12 levels were 398 pg/mL (pre-transplant), 892 pg/mL (1 month post), and 430 pg/mL (6 months post). The second time point had significantly higher B12 levels (p < 0.001). Median folate levels were 9.7 ng/mL, 6.95 ng/mL, and 11.3 ng/mL at the respective time points (p < 0.05), with the second time point significantly lower. Conclusions: Pediatric HSCT patients experience increased demands for B12 and FA despite accurate treatment, leading to potential deficiencies. Close monitoring, early supplementation, and supplementing high levels of these micronutrients are essential.