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Aim: Overall survival from leukemia is less in low and middle-income countries than in high-income countries. The aim of this study is to review febrile neutropenia (FN) episodes in children with acute lymphoblastic leukemia (ALL) treated with BFM (Berlin-Franfurt-Münich) protocols at a single center in Turkey. Methods: Retrospective data were extracted from medical records of children (1-18 years old) with newly diagnosed and relapsed ALL and who were treated between 1995-2010 at Istanbul University, Cerrahpasa Medical Faculty, Pediatric Hematology Oncology Dept. Results: Two hundred -forty-five FN episodes were detected in 96 evaluable children (mean age: 5.9±3.7 years; M/F: 50/46). According to BFM risk groups; 32 were SRG (standard risk group), 56 were MRG (medium risk group) and 8 were HRG (high risk group) patients. Fifteen patients had relapsed on follow-up and 2 of them had a second relapse. The mean number of FN episodes was 2.5 (±1.58; 0-8) per newly diagnosed patient and 3.6 (±1.88; 1-8) per relapsed patient. Febrile neutropenia episodes were more frequent at high risk patients compared to standart risk patients (p≤0.05). Patients diagnosed before year 2000 had less FN episodes compared to patients diagnosed after 2000 (p≤0.05). Fifty-seven of the FN episodes were fever of unknown origin, 16% were clinically documented infection and 27% were microbiologically documented infection. Of the microbiologically documented infections, 44% of them were caused by gram positive bacteria and 43% were by gram negative bacteria. Eight of 96 patients developed invasive fungal infection during initial treatment and 4 out of 15 patients who relapsed. Of 9 patients who expired on follow-up, the cause of death was fungal infections in 4 and FN in 1. Conclusion: The high rate of infectious deaths in leukemia compared to that reported in high-income countries, suggests that improvements in infection care and prevention are necessary to improve survival in patients with leukemia. We showed that over the years FN episodes increased at our center in contrast to better quality of patient care. This increase in infections may be atrributed to more intensive treatment regimens. We also showed that high risk and relapsed patients who are treated more aggresively have increased infection rate. The most common cause of death was fungal infections. Disclosures No relevant conflicts of interest to declare.

Aim: To investigate the clinical features, diagnostic and treatment results and long-survival of children with HL at a single center in Turkey. Methods: Retrospective data were extracted from medical records of children ( Results: Twohundred-fortyeight patients (M/F: 1.8) were identified for analysis. Mean age at diagnosis was 10 years. Four-percent were stage 1, 43% were stage 2, 34% were stage 3 and 17% were stage 4 at diagnosis. B symptoms were present in 105 children (42%). Mixed cellular was the most common subtype (50%) followed by nodular sclerosis. MOPP regimen was primarily used until 1989 along with extended field radiotherapy (30-40 Gy) after 1989 ABVD with involved field RT (20-25 Gy) was the treatment of choice. Onehundred-fortyseven patients (42%) had radiotherapy. Median follow-up time was 14.3 years (range: 5 months-38 years). PET was used for assessment in 45 cases. Ten year overall survival rate was 99%. Ten year event free survival rate (EFS) was 90%. Univariate analysis showed that stage, histological subtype, presence of B symptoms and hematological parameters were not related to OS while treatment regimen correlated. Twenty-six patients relapsed and 17 patients expired on follow-up. Ten patients who relapsed were treated with autologous stem cell transplantation, 3 of them relapsed again and were treated with brentixumab. Secondary tumours developed in 4 patients (1.6%). One had AML, 1 osteosarcoma, 1 thyroid papillary cancer and 1 had craniopharyngioma. Conclusion: Ethnic and regional differences in the epidemiology and pathological aspects of HL may be associated with differences in clinical features and prognosis however we found that clinical features and treatment outcomes are similiar in Turkish patients. Our results showed that hematological parameters and B symptoms were not significant prognostic parameters. Disclosures No relevant conflicts of interest to declare.