Jan Styczyński 1, Iwona Hus 2, Katarzyna Derwich 3, Tomasz Szczepański 4, Lidia Gil 5, Tadeusz Robak 6, Elżbieta Kasprowicz 7, Wiesław W. Jędrzejczak 8
1 Katedra Pediatrii, Hematologii i Onkologii, Collegium Medicum, Bydgoszcz, Polska
2 Samodzielna Pracownia Transplantologii Klinicznej, Uniwersytet Medyczny, Lublin, Polska
3 Klinika Onkologii, Hematologii i Transplantologii Pediatrycznej, Uniwersytet Medyczny, Poznań, Polska
4 Katedra i Klinika Pediatrii, Hematologii i Onkologii Dziecięcej, Zabrze, Śląski Uniwersytet Medyczny w Katowicach, Polska
5 Katedra i Klinika Hematologii i Transplantologii, Uniwersytet Medyczny, Poznań, Polska
6 Klinika Hematologii, Uniwersytet Medyczny, Łódź
7 Narodowy Fundusz Zdrowia, Kujawsko-Pomorski Oddział Wojewódzki, Bydgoszcz, Polska
8 Katedra i Klinika Hematologii, Onkologii i Chorób Wewnętrznych, Warszawski Uniwersytet Medyczny, Warszawa
Słowa kluczowe:
- dzieci
- dorośli
- nowotwory hematologiczne
- problem „przejścia”
Keywords:
- Children
- Adults
- Hematological malignancy
- “Transition” problem
Abstract
Background: Patients cured from hematological malignancies should be subject to longlife routine medical supervision. Patients who did not complete their therapy during childhood require further therapy when reaching adulthood (18 years). Objective: Determination of guidelines and suggestions on proceeding with pediatric patients with hematological malignancies undergoing transition to adult hematology centers, with respect to Polish conditions of national medical health-care system. Methods: Panel of experts in thefield of pediatric and adult hematology analyzed current situation in Polish pediatric and adult hematology centers and reviewed the literature on transition process of minor patients from pediatric to adult setting. Results: Factors determining problems of patient transition and models of care of patient in pediatric and adult hematology settings were analyzed. Existing models of transition in Poland as well as experience from international models were presented: model of direct transition, model of adolescence medicine, sequential model and consultation model. Suggestions of changes facilitating
process of patient transition, and guidelines on proceeding with patients with respect to diagnosis of malignancy and phase of oncological therapy were presented, involving cooperation of pediatric and adult centers, specialists in pediatric hematology and adult hematology, as well as the payer and scientific societies. Conclusions: Process of transition of patients requires coordination and cooperation, preferably at the level of medical institutions. This should ensure optimal medical care to patients cured from malignancy and facilitate long-term medical supervision and gathering data on treatment efficacy and side effects.
