When a child has a blood disorder or suspected cancer, families need clear information and coordinated care. MPGCARE helps arrange pediatric hematology and oncology reviews at Medical Park and Liv Hospital in Türkiye. Hospital specialists diagnose and plan treatment; MPGCARE coordinates appointments and records requested by the receiving team.

Hematology covers blood cells, clotting and bone marrow conditions, including many non-cancerous disorders. Oncology covers childhood cancers; leukemia and lymphoma overlap both specialties. Anaemia, bruising or an enlarged lymph node does not by itself mean cancer. Persistent or worsening symptoms need assessment rather than conclusions based on a single result.

The following symptoms are not diagnostic by themselves. This is a guide to conditions the specialty assesses, not a promise that every method or treatment is available at every centre. The receiving team confirms individual indications.

Disease	Symptoms and family concerns	Tests selected by the physician
Iron-deficiency anemia	Pallor, tiredness, reduced appetite or pica. Discuss diet and possible blood loss; do not assume every anemia needs iron.	CBC and red-cell indices, ferritin and selected iron studies; reticulocytes or smear when needed. Inflammation affects interpretation.
Vitamin B12-deficiency anemia	Fatigue, pallor and sometimes neurological or developmental changes. Restrictive diets and absorption problems matter.	CBC, vitamin B12 and selected folate/metabolic tests; evaluate the cause of deficiency.
Thalassemia	Persistent anemia, poor growth or a family history. Bring newborn screening and transfusion records.	CBC, reticulocytes, hemoglobin electrophoresis/HPLC and selected genetic testing. Iron is used only if deficiency is confirmed.
Sickle cell disease	Anemia, painful episodes or infections. Fever and breathing difficulties require urgent attention under the care plan.	Hemoglobin analysis, previous newborn-screening results and selected genetic tests; organ assessment depends on symptoms.
Immune thrombocytopenia (ITP)	Small skin spots, bruising, nose or gum bleeding. Report significant bleeding immediately.	CBC and blood smear; clinician excludes other causes of low platelets. Bone-marrow examination is not routine in a typical presentation.
Hemophilia	Prolonged bleeding, joint swelling or bleeding after procedures; tell the team before surgery or dental care.	Coagulation tests, factor VIII/IX levels; inhibitor testing and genetic analysis when indicated.
Aplastic anemia	Fatigue, recurrent infection and bleeding may occur together. Bring medication/exposure and family history.	CBC, reticulocytes and bone-marrow assessment; selected genetic or other tests distinguish acquired and inherited marrow failure.

Disease	Symptoms and family concerns	Tests selected by the physician
Acute lymphoblastic leukemia (ALL)	Persistent pallor, bruising, fever or bone pain require assessment; these symptoms are not specific to leukemia.	CBC/smear, bone-marrow examination, flow cytometry and cytogenetic/molecular tests. Measurable residual disease helps assess treatment response.
Acute myeloid leukemia (AML)	Fatigue, infections and bleeding; prompt review is needed for persistent or worsening symptoms.	CBC/smear and marrow examination with flow cytometry, cytogenetic and molecular tests; response testing follows the protocol.
Hodgkin lymphoma	Persistent enlarged nodes, unexplained fever, night sweats or weight loss. Report progression.	Appropriate tissue biopsy and immunohistochemistry; blood tests and selected CT/MRI/PET imaging for staging.
Non-Hodgkin lymphoma	Rapidly enlarging nodes or masses, abdominal swelling or breathing difficulty. Breathing difficulty needs urgent local care.	Tissue biopsy with immunohistochemistry/flow cytometry and selected molecular tests; imaging and other staging tests by indication.
Brain and central nervous system tumours	Persistent headache with vomiting, gait or vision changes or seizures. New neurological signs require urgent assessment.	Neurological examination and MRI; tissue/molecular assessment only when the specialist team considers it appropriate.
Neuroblastoma	Abdominal mass, bone pain or unexplained systemic symptoms. Discuss symptom duration and growth.	Selected imaging, urine catecholamine metabolites (VMA/HVA) and tumour tissue/biological studies; marrow/staging investigations when indicated.
Wilms tumour	Abdominal swelling or mass, blood in urine or raised blood pressure. Do not press on a suspected abdominal mass.	Ultrasound, selected kidney/abdominal and chest imaging, renal function. The specialist protocol determines whether biopsy is appropriate.
Osteosarcoma	Persistent focal bone pain, swelling or reduced movement; do not dismiss progressing symptoms as growth pains.	X-ray and MRI of the involved region; biopsy planned by the specialist surgical team and selected staging imaging.
Ewing sarcoma	Bone pain/swelling, sometimes fever; persistent symptoms need investigation.	Local imaging, specialist-planned biopsy and selected molecular confirmation; staging tests according to findings.
Rhabdomyosarcoma	An enlarging soft-tissue mass or symptoms depending on its location, such as eye or urinary changes.	Site-specific imaging and planned biopsy with immunohistochemistry and selected molecular tests; staging guided by the team.

Consultation reviews symptoms, growth, family history, medicines and examination. Blood tests and imaging answer selected questions. Bone marrow sampling, tissue biopsy and lumbar puncture are procedures with separate indications, consent, preparation and sometimes anaesthesia. Not every child needs them, and PET-CT is not a routine test for every condition. The receiving team confirms child-specific preparation; this page gives no fasting times, doses or medicine-change instructions.

For non-cancerous blood disorders, care may involve replacement of a confirmed deficiency, disease-specific medicines, transfusion support or other specialist treatment. Cancer treatment depends on the confirmed type, stage/risk group, molecular findings and previous response; chemotherapy, surgery, radiotherapy or selected targeted/immune treatments may be considered. Transplantation and advanced therapies require specific eligibility and centre confirmation. No treatment method or recovery outcome is guaranteed.

Provide the complete dated pathology report with the specimen site, collection date and accession/reference number, plus immunohistochemistry, flow-cytometry, cytogenetic and molecular reports when performed. Add bone marrow and measurable residual disease (MRD) results if relevant. A report is different from slides or paraffin blocks. If material review is requested, the sending pathology laboratory and receiving centre must confirm exactly what is needed, labelling, permissions, transport and return arrangements. Do not repeat a biopsy or ship material independently just to seek an enquiry.

Ask the treating team for a chronological summary: confirmed diagnosis and diagnosis date, stage/risk group, protocol, drug names and doses already given, cycle dates and last treatment, operations, radiotherapy site/dose, response and pending results. Include admissions, infections/toxicities, transfusions, allergies, current medicines, central-line information and the next planned step. Add recent blood counts/organ-function tests, imaging reports and full DICOM files when available. Confirm translation and secure sharing; do not send private child records through a public webpage.

State the question: confirmation of diagnosis, pathology review, treatment alternatives, relapse assessment or follow-up. MPGCARE helps identify the receiving specialty and records it requests. The specialist reviews the available file and may request material, additional tests or an examination before a written opinion. A remote review may have limits and does not automatically transfer clinical responsibility. Availability and timing are confirmed with the centre; urgent care must not be delayed for a second opinion.

With parent/legal-guardian permission, agree who shares records, who remains the lead clinician, what the receiving team will review and how recommendations reach the current team. Continue the prescribed plan while a review is being arranged unless the treating clinician advises otherwise. Families should not stop chemotherapy, steroids or other treatment or change a schedule independently. Any transfer requires an agreed handover, updated medicines/results, emergency contacts and confirmation that the child can safely travel.

Confirm the pediatric hematologist/oncologist, pathology and radiology reviewers, relevant surgeons/radiation specialists and supportive-care team. Agree a named family contact, interpreter, update schedule and written answers to important questions. Include the child in an age-appropriate way and respect privacy. Ask about infection prevention, nutrition, pain, school, psychological support and treatment effects on growth or fertility when relevant. MPGCARE coordinates communication; clinical advice and emergencies belong to the medical team.

Ask for a written fever/infection and bleeding action plan, the team’s urgent contact and the nearest emergency service. Wash hands, avoid close contact with unwell people and follow the team’s instructions for mouth care and catheter care. Discuss vaccines and exposure to chickenpox or other infections with the treating team; do not arrange live vaccines independently during immunosuppressive treatment.

Keep an up-to-date medication list and treatment calendar. Check every medicine, pain reliever, supplement or herbal product with the team; avoid independent dose changes. Ask whom to call after a missed dose, vomiting or difficulty taking medicine. Report new bruising, blood in urine/stool or bleeding; discuss safe activity and dental procedures when bleeding risk is present.

Track eating, drinking, urine output, weight and activity. Report persistent vomiting, diarrhoea, poor intake, dehydration or uncontrolled pain. The team/dietitian should tailor nutrition and food-safety advice; restrictive “anticancer” diets must not replace treatment.

Support sleep, school contact, age-appropriate explanations and emotional needs. Ask for psychological and social support and, when relevant, counselling about growth, puberty and fertility before treatment. Do not blame the child or family for the diagnosis; involve the child appropriately while protecting privacy.

During cancer treatment, fever or signs of infection can be urgent, especially with low neutrophils. Follow the treating team’s written fever plan and contact them immediately; do not wait for an overseas review. Uncontrolled bleeding, breathing difficulty, severe weakness, collapse, reduced consciousness or new neurological symptoms require urgent local assessment/emergency services. Persistent pallor, unexplained bruising, bone pain, swelling or weight loss also merit timely review but are not specific to cancer.

Agree who reviews pending pathology/tests, how results are delivered, treatment and monitoring schedules, and out-of-hours contacts. Home-country follow-up may be possible if a local clinician accepts responsibility and receives the handover. Confirm access to medicines, transfusion/support services and the limits of remote appointments. After cancer treatment, request a written survivorship plan for relapse surveillance and possible late effects; the tests and visit intervals depend on the diagnosis and treatment received.

Tell MPGCARE the child’s age, current diagnosis or concern, treating hospital, treatment status and the question you want reviewed. Confirm the receiving hospital/team, available services, interpreter needs, required visits and written scope before planning travel. A document review does not replace all clinical examinations.

Contact: +90 850 259 5553

National Cancer Institute · NHLBI · Liv Hospital