FEATURE
Features
The years spent transitioning from adolescence to adulthood are flush with emotional, financial, and social
challenges, but for young adults who are also dealing
with a hematologic malignancy or chronic condition,
these transitional years have many added layers of
complexity.
As adolescent patients move into adulthood, they are
often moving from a state of dependence to independence – like moving from high school to college or from
their parents’ house to their own apartment – but that
also means suddenly being responsible for their own
medical appointments, medications, and health-care
insurance.
“For patients with a chronic illness, transitioning
care from a pediatric to adult setting can be a really
difficult time,” said Harriet Bering, MD, site medical
director of Harvard Vanguard Medical Associates, an
affiliate of Atrius Health, in Cambridge, Massachusetts.
“Many patients are very attached to their pediatric providers. Getting to know a new team after having a long
illness can be difficult – especially during this critical
time when people are going through the maturing process with all the different emotional issues related to it.”
A variety of hematologic conditions can be diagnosed during childhood or adolescence (between the
ages of 10-19 years, according to the World Health
Organization’s definition). These conditions can range
from childhood leukemias or iron deficiencies to even
rarer conditions like hemophilia or sickle cell disease
(SCD), which require long-term, complex, and specialized care.
ASH Clinical News spoke with several physicians
about transitioning young adult patients to the adult
system and what can be done to make this transition
smooth and successful for the patient, their caregivers,
and their health-care team.
Is Age Just a Number?
Coming of Age
The transition and transfer of patients with
hematologic conditions from pediatric to
adult care often comes at a crucial time.
ASHClinicalNews.org
In most states, the legal age of adulthood is 18 years,
though the same may not always be true when it comes
to health care.
“There is really no clear age of transition, and the age
seems to differ according to where the patient is being
treated,” said Anjali Advani, MD, a staff physician in
the Leukemia Program, Department of Hematologic
Oncology and Blood Disorders and director of inpatient
leukemia at Cleveland Clinic in Cleveland, Ohio. “Here
at Cleveland Clinic, we tend to see many patients that
are 18 and older, but I know of other places with pediatric programs where they will sometimes see patients
into their 30s.”
According to Amy E. Sobota, MD, MPH, a pediatric
hematologist/oncologist at Boston Medical Center in
ASH Clinical News
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