Background: Transfusion Services in Saudi Arabia are mainly hospital-based, where each major hospital recruit donors, test for Hepatitis B service antigen (HBs Ag), Hepatitis C antibody (Anti-HCV), Human Immune Deficiency Virus antibody (Anti-HIV), and Nucleic Acid Testing (NAT) for HBV-DNA, HCV-RNA, and HIV-RNA. In addition, Anti-HBc and Anti-HBs titer are tested for those who are negative for HBs Antigen and NAT, so that blood products from donors with high Anti-HBs titer (>100 u/ml) can be used. The aim of this limited retrospective study is to find out the prevalence of Anti-HBc among blood donors in different blood donation centers in Riyadh city, Saudi Arabia and current policies regarding blood utilization from donors with positive Anti-HBc. Materials and Methods: We reviewed blood donor records in 4 large hospitals in Riyadh between 2011-2015. Hospital names are not disclosed for confidentiality reasons. Instead, they were named A, B, C, and D Results: (see Table) 1- The overall prevalence of Anti-HBc positive blood donors is 6.2%, however, there is a significant variation among institutions ranging from 2.8 % to 11.1 % (which needs to be investigated to explain reasons for this variation). 2- Some institutions defer all donors with positive anti-HBc (although they carry out all tests), while others carry out anti-HBs and NAT testing and use blood with high titer anti-HBs (> 100 u/ml). Conclusion: There is a need for an expert consensus opinion regarding the cost-effectiveness of anti-HBc for either donor deferral or proceeding to NAT and anti-HBs titer testing. Such a consensus is practiced in many countries, based on the prevalence of anti-HBc and the availability of NAT testing Disclosures No relevant conflicts of interest to declare.

Chronic myelomonocytic leukaemia (CMML) and juvenile myelomonocytic leukaemia (JMML) are two disease entities that come under the myelodysplastic/myeloproliferative neoplasms category. Each of the two conditions has its own diagnostic criteria. In addition, they have different ages of presentation; while CMML is typically a disease of the elderly, JMML is a disease of young children. Here we are presenting the case of a 27-year-old male patient who, at the time of diagnosis, fulfilled the diagnostic criteria of both diseases. In addition he had radiological changes of type 1 neurofibromatosis. Possible explanations of the patient case have been discussed.