Background Many patients with sickle cell disease (SCD) require chronic transfusion therapy due to high stroke risk. Transfusion hemosiderosis is a major complication that can cause end-organ damage. Iron chelation therapy reduces iron overload, and low-dose vitamin C supplementation has been shown to improve chelation efficacy in transfusion-dependent beta-thalassemia. Objective To assess the prevalence of vitamin C deficiency in pediatric patients with SCD on chronic transfusion and explore its association with iron burden, liver injury, and micronutrient status. Methods We performed a retrospective chart review of 75 pediatric patients with SCD receiving chronic transfusions. Patients were categorized as vitamin C sufficient (≥23 μmol/L) or deficient (<23 μmol/L) and compared by serum ferritin, ALT, and selected micronutrient levels. Results Of 75 patients, 47 (63%) were vitamin C-deficient (median 9.0 μmol/L) and 28 (37%) were sufficient (median 39.0 μmol/L). Vitamin C-deficient patients had significantly higher ferritin (median 3555 ng/mL) than sufficient patients (median 2504 ng/mL) (p < 0.01). Elevated ALT was observed in 27.7% of vitamin C-deficient patients compared to 3.6% in the sufficient patients. Conclusion Vitamin C deficiency was highly prevalent in our patients and was associated with higher serum ferritin and a greater prevalence of elevated ALT; however, MR LIC did not differ significantly according to vitamin C status. These findings do not establish greater total-body iron burden or impaired chelation efficacy and should be considered hypothesis-generating. These findings suggest the need for prospective studies to determine whether vitamin C status influences iron chelation efficacy in patients with SCD receiving chronic transfusion therapy.
Effective information, education, and communication (IEC) are vital to empowering families, improving treatment adherence, and optimizing pediatric cancer outcomes in India. However, significant gaps persist in systematic, culturally appropriate, and accessible health communication. Current evaluations reveal that only half of tertiary centers provide physical IEC materials, while existing resources remain predominantly English-centric and fragmented across platforms, leaving critical domains such as survivorship, financial guidance, and psychological care underserved. To bridge these divides, multi-stakeholder initiatives including the Indian Childhood Cancer Initiative (ICCI), parent-led networks, and specialized digital platforms are curating centralized repositories, developing multilingual video-based tools, and leveraging lived experiences. Strengthening India's childhood cancer communication ecosystem requires health system-level commitments: embedding patient education into care standards, sustaining multilingual content co-design, optimizing digital infrastructure, and dedicating funding for continuous resource evaluation and development.
On May 21-22nd 2026 a National Stakeholders conference was held in New Delhi by the Indian Childhood Cancer Initiative (ICCI) to review the different areas of collaboration needed to improve childhood cancer care in India, and the progress that has been made. This article provides a focused overview of Workforce development, primarily Nursing and Medical Staff, but recognizing that every member of a pediatric oncology unit plays a valuable role. Incorporating the data displayed at the conference, this article recaps the overall needs and goals which are as follows: 1) better collaboration between ICCI and the Indian Academy of Pediatrics -- Pediatric Hematology Oncology Chapter to create a robust database and address Workforce Challenges 2) to work towards being compliant with the Workforce and Training recommendations of the SIOP Guidance Standards Framework for Paediatric Oncology Units in Low- and Middle-Income Countries 3) to support and recognize the role of the specialist pediatric hematology oncology nurse 4) to appoint dedicated pediatric hematologists-oncologists and ensure adequate trained nursing staff at all medical centers treating such children 5) to define required competencies and strengthen training of personnel at all levels of care.
