Background: Central venous catheters (CVCs) are the main cause of venous thromboembolism (VTE) in critically ill children. The optimal first-line treatment for children with asymptomatic CVC-related VTE is unknown. Due to a paucity of clinical trials, clinical practice guidelines can offer only weak recommendations for the management of asymptomatic CVC- related VTE. Method: This case-based survey was designed to assess current trends in local management strategies for pediatric patients with an asymptomatic CVC- related thrombosis. The survey focused on the use of the thrombophilia testing, management approach, duration of anticoagulation, and the use of secondary prophylaxis. We hypothesize that there will be significant variation in these four management areas, in large part due to the aforementioned paucity of available data.REDCap® questions were sent to members of the Saudi Arabian Pediatric Hematology/Oncology Society (SAPHOS) clinical forum/email database. We used a hypothetical case scenario to assess management strategies for asymptomatic CVC-related VTE and secondary prophylaxis. Results: Seventy-one (30%) physicians responded to the survey. The majority of the respondents (83.3%) did not use thrombophilia testing. The far majority (95%) treated with anticoagulation. In contrast, the survey respondents varied widely in the duration of anticoagulation and the use of secondary prophylaxis. Conclusions: Asymptomatic CVC-related VTE is a common clinical entity with limited data guiding management. In Saudi Arabia, there remains considerable variability in clinical management. These findings will help identify crucial knowledge gaps in the management of asymptomatic CVC-related VTE and facilitate clinical trials that will help establish evidence-based treatment guidelines

Background: On January 2020, the WHO declared the novel coronavirus (2019-nCoV) outbreak as a public health emergency of international concern. Due to rapid spread 2019-nCoV, all countries started preventive and precautionary measures to prevent COVID-19 infection spread. These measures limited the population mobility and services provided, which subsequently Impact of on children with cancer and cancer care delivery in the many health centers in Saudi Arabia. Procedure: We did a cross sectional study to assess the impact on this outbreak on children with cancer with regard to all aspects of life including medical services provided, the specific precautions to prevent spread in cancer patients, mental, psychological effect and its affection on quality of life. Results: We collected 204 responses during a survey which assessed the impact on the treatment of cancer children at a tertiary institution during the COVID-19 pandemic. The majority of patients were receiving ongoing chemotherapy for leukemia/lymphoma. The majority of these patients (60.5%) reported a delay in treatment received due to hospital cancellation. Although, the majority of patients in our cohort complained of delayed treatment, fortunately none of the delays led to fatalities. In the context of global lockdowns and physical distancing to help flatten the COVID-19 curve, telemedicine has proved fundamental to keeping patients and their healthcare providers connected and safe. Children also faced multiple other difficulties such as psychosocial issues during the COVID-19 pandemic. Conclusion: Our long-term goals are to develop new programs which will enable children with cancer to emerge successfully during a pandemic.