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Background: The aim of this study was to assess the impact of serum panel reactive antibodies (PRA) on the outcomes of allogeneic hematopoietic stem cell transplantation (HSCT) in pediatric thalassemia patients. Methods: A total of 73 pediatric patients with thalassemia were included in this single‐center study. Pre‐transplant PRA levels were evaluated, and the patients were divided into two groups: PRA‐negative (group 1; n = 44) and PRA‐positive (group 2; n = 29). Patient characteristics, including age, gender, donor type, stem cell source, and HLA compatibility, were analyzed. Transplant outcomes, including engraftment, transfusion requirements, and transplant‐related complications, were compared between the two groups. Further subgroup analysis was performed based on MFI values. Results: At the time of transplantation, patients in group 1 were younger than those in group 2 (p =.008). The number of fully matched donors within the family (MSD and MFD) was significantly higher in group 1 (p =.049). Additionally, Rh blood group incompatibility was higher in group 2 (p =.03). There was no statistically significant difference in the engraftment days of neutrophils, platelets, and erythrocytes between the two groups. The frequency of poor graft function and graft failure was higher in the group 2, but there was no statistically significant difference. Post‐transplant transfusion requirements for platelets and red blood cells were significantly higher in the group 2 (p <.001). Transplant‐related complications such as VOD, PRES, and aGvHD were more common in the group 2, but no statistical significance was detected. Conclusions: Serum PRA in pediatric thalassemia patients may impact the outcomes of HSCT. PRA‐positive patients had higher rates of blood product transfusion requirements. Although poor graft function, graft failure, and post‐transplant complications were more common in the group 2, statistical significance was not observed. Identifying patients with high PRA levels can assist in optimizing transplant strategies and post‐transplant care, leading to improved outcomes for the patients. [ABSTRACT FROM AUTHOR]

Background: Ifosfamide (IFO) is an alkylating agent used to treat broad range of malignancies. One of the life-threatening toxic effects is reversible neurotoxicity. In this report; we presented a case report of ifosfamide induced encephalopathy (IIE) in a child with osteosarcoma in order to emphize that it is important to continue ifosfamide treatment as well as the importance of this potentially fatal complication. Case report: Following the 20th week of ifosfamide treatment, the patient's follow-up with the diagnosis of osteosarcoma developed neurological findings. Laboratory analyzes before and after ifosfamide infusion were normal. No pathological findings were seen on MR imaging. Hypoglycemia, electrolyte disturbances, encephalitis, meningitis, metastasis and posterior reversible encephalopathy syndrome (PRES) were not considered. Electroencephalography was found compatible with neuronal hyperexcitability originating from the left hemisphere. With the diagnosis of ifosfamide induced encephalopathy, prophylaxis with methylene blue was received before the next infusion of ifosfamide. Neurological findings were not observed in the patient's follow-up. Conclusion: Patients who develop IIE can continue their treatment protocol with methylene blue prophylaxis and supportive therapy. [ABSTRACT FROM AUTHOR]

Spontaneous colonic cast excretion per anus is a very rare entity. Colonic ischemia and severe infections are the most common etiologic factors. It is mostly seen in adults. Only one pediatric patient with colonic cast excretion was reported in the literature. We present a three-year-old male patient with the diagnosis of neuroblastoma who had undergone autologous BMT. After suffering a prolonged rotavirus infection, on the 25th the post-transplantation day, he presented with nausea, vomiting, abdominal pain, and spontaneous excretion of colonic mucosa-like material via defecation. The histopathological interpretation of the excreted material revealed acellular material composed of fibrin and neutrophils. The patient's colonoscopic biopsy specimen revealed crypt distortion, regeneration, and numerous apoptotic bodies within the crypt epithelium. Apoptotic colopathy and colonic cast excretion per anus is a sign of ischemia, which may be caused by severe intestinal infections or rarely, graft-versus-host disease. Therefore, a clinicopathological correlation was performed to reach a definitive diagnosis. The patient's symptoms were attributed to severe, prolonged rotavirus infection. [ABSTRACT FROM AUTHOR]

Objective: Celiac disease (CD) and Immune thrombocytopenic purpura (ITP) may occur together as a result of similar autoimmune mechanisms. The aim of this study was to assess the frequency of CD in a group of ITP patients and in the literature., Methods: A total of 29 patients in Pamukkale University Faculty of Medicine Hospital Pediatric Hematology and Oncology Department with ITP were included in the study. Test was performed for the antibodies related to CD. Positive result for celiac antibodies was confirmed with biopsy. The results were compared with the literature., Results: Of the study group, 13 patients (44.8%) were female and 16 (55.2%) were male. The mean age was 7.2±4.7 years and mean platelet count at the time of admission was 13,440±11,110/mm 3 (range: 2000-41,000/mm 3 ). Twelve patients (41.4%) were diagnosed as acute ITP, 6 patients (20.7%) as persistent ITP, and 11 patients (37.9%) as chronic ITP, according to the duration of thrombocytopenia. Antibody positivity was detected in 1 patient. Histological evaluation was compatible with CD. Results were compared with studies regarding the prevalence of CD in the population. No significant difference was found., Conclusion: Although it is not necessary to perform CD test in every case of ITP, the presence of differential diagnosis of CD is important to prevent unnecessary treatment, especially in ITP patients with growth retardation or malabsorption findings., Competing Interests: Conflict of Interest: None declared.

Leishmaniasis is a reticuloendothelial system disease that mostly observed before the age of 5. Visceral infection causes long-standing fever, weight loss, weakness, pancytopenia, and hepatosplenomegaly. Leishmania infantum is responsible for visceral leishmaniasis (VL) in Turkey. We present a case of hemophagocytic syndrome due to Leishmania infection diagnosed with an immunofluorescence antibody test (IFAT). Leishmania amastigotes were not observed on bone marrow aspiration. We consider that IFAT is very important for parasite detection in the diagnosis of VL in children, particularly when amastigotes are not obtained on bone marrow aspiration.