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Aims: Cancer in children can adversely affect their quality of life. Evaluation of health related quality of life (HRQoL) during the process of treatments is important for recognition of acute dysfunction related to therapy and disease. The aims of this study was to assess the HRQoL of cancer children with using the Pediatric Quality of Life InventoryTM (PedsQLTM) and to assess the influence of cancer type dan duration of treatment to their quality of life. Methodology: This cross-sectional study was conducted at the age of 2-18 years of pediatric cancer patient in the Children Haematology Oncology’s Ward at the Ulin Hospital Banjarmasin from November to Desember 2022. Subject and their parents were assessed using the PedsQLTM Generic Core Scales and Cancer Module, which consist of parent-report and/ or child-report. Results: A total number of 59 children participated in this study, mean age 8.4 years old, 38 (64.41%) were male. Non solid tumor represented 62.5% of the sample, with the highest percentage for leukemia (62.71%). Parent had reports about having lower quality of life on the assessment than their children (p< 0.05). Children with solid tumor had more problem in procedural anxiety than non-solid tumor, and HRQoL children with duration of therapy more than 1 year was significantly better than the children who had duration of therapy less than 1 year on pain and hurt domain (p< 0.05). Conclusion: Children cancer in Ulin Hospital Banjarmasin have low quality of life based on parent reports, especially in school function. Children cancer with solid tumor had more problem in procedural anxiety, and also shorter duration of therapy had more problem in pain and hurt. Special care and psychosocial support to children and their parent is needed to improve their HRQoL during treatment.

Oxidative stress in β-TM (beta-thalassemia major) patients is associated with increased of malondialdehyde (MDA) level and also decreased of superoxide dismutase (SOD) level. Deferiprone and deferasirox, which are used for the treatment of iron overload, exhibit antioxidant potential. However, various clinical studies have shown an increase in creatinine levels in pediatric patients receiving oral iron chelator. There was limited study assessed oxidative stress and impact of β-TM on the renal function, especially in children that growing up with β-TM and receiving iron chelator. Therefore, the aim of the study is to investigate renal function and oxidative stress between β-TM patients at Ulin Hospital Banjarmasin who received deferasirox and deferiprone. Ninety β-TM patients (aged 2-≤18 years) with regular iron chelators (deferiprone or deferasirox) use at Ulin Hospital between October-December 2020, were included in this cross-sectional study. Laboratory examinations included complete peripheral blood count, serum ferritin, urea, creatinine, MDA and SOD. Statistical analysis was used to compare all parameters between two groups.There was no significant difference in the levels of MDA (p= 0.663), SOD (p= 0.102), urea (p= 0.597), creatinine (p= 0.067) and glomerular filtration rate (p= 0.792) between the two groups. In this study, 9 patients had decreased GFR, of which 3 patients (33.3%) were taking DFX. Thus, 13.6% of DFX users (3 of 22 patients) and 8.8% of DFP users (6 of 68 patients) had decreased renal function. In general, the mean glomerular filtration rate (GFR) of the patients in this study ranged from 126.74± 32.71ml/kg/min/1.73m2. For conclusion, deferiprone and deferasirox had no significant difference in terms of protection against oxidative stress. However, the decline in renal function occurred slightly higher in deferasirox users. Early recognition will be an important key to prevent renal complication

Background: Although numerous patient specific co-factors have been shown to be associated with worse outcomes in COVID-19, the prognostic value of thalasemic syndromes in COVID-19 patients remains poorly understood. Aims: We studied the outcomes of 137 COVID-19 patients with a history of Transfusion Dependent Thalassemia (TDT) and non-Transfusion Dependent Thalassemia (NTDT) extracted from a large international cohort and compared them with the outcomes from a matched cohort of COVID-19 patients with no history of thalasemia. Results: The mean age of thalassemia patients included in our study was 41±16 years (48.9% male). Almost 81% of these patients suffered from TDT requiring blood transfusions on a regular basis. 38.7% of patients were blood group O. Cardiac iron overload was documented in 6.8% of study patients, whereas liver iron overload was documented in 35% of study patients. 25% of thalassemia patients had a history of splenectomy. 27.7% of study patients required hospitalization due to COVID-19 infection. Amongst the hospitalized patients, one patient died (0.7%) and one patient required intubation. Continuous positive airway pressure (CPAP) was required in almost 5% of study patients. After adjustment for age-, sex- and other known risk factors (cardiac disease, kidney disease and pulmonary disease), the rate of in-hospital complications (supplemental oxygen use, admission to the an intensive care unit for CPAP therapy or intubation) and all-cause mortality was significantly lower in the thalassemia group compared to the matched cohort with no history of thalassemia. Amongst thalassemia patients in general, the NTDT group exhibited a higher rate of hospitalization compared to the TDT group (p=0.001). In addition, the rate of complications such as acute kidney injury and need for supplemental oxygen was significantly higher in the NTDT group compared to the TDT group. In the multivariable logistic regression analysis, age and history of heart or kidney disease were all found to be independent risk factors for increased in-hospital, all-cause mortality, whereas the presence of thalassemia (either TDT or NTDT) was found to be independently associated with reduced all-cause mortality. Conclusions: The presence of thalassemia in COVID-19 patients was independently associated with lower in-hospital, all-cause mortality and few in-hospital complications in in our study. The pathophysiology of this is unclear and needs to be studied in vitro and in animal models. Trial Registration for sources of data extraction: NCT: 04334291, 04746066 Funding Statement: This study was funded by a non-conditioned grant from FUNDACION INTERHOSPITALARIA PARA LA INVESTIGACION CARDIOVASCULAR, FIC. (Madrid, Spain). This nonprofit institution had no role in the study design, the collection, analysis and interpretation of data, the writing of the report, or the decision to submit the paper for publication. Declaration of Interests: The authors declare no conflicts of interest. Ethics Approval Statement: The study was approved by the Ethics Committees in all of the centers involved (Banjarmasin, Bari, Cagliari, Catania, Ferrara, Gela, Genoa, Getafe, Guadalajara, Legan, Madrid, Mannheim, Milan, Monza, Naples, Olbia, Padua, Pavia, Ragusa, Rome, Salerno, Turin, Valladolid and Verona).