Hematologist
CION Cancer Clinics
Moving from paediatric to adult haematology care | CION Cancer Clinics
Transition means your child's blood cancer or blood disorder follow-up moves from a children's team to an adult haematology team, usually in the late teenage years. It works best as a planned process over several visits, with a written treatment summary and a young person who knows their own history. This guide covers what changes, who needs what follow-up, what to gather, and what to ask. At CION Cancer Clinics, our haematology team supports patients and families through treatment, cost questions and life at home.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- What does moving from paediatric to adult haematology mean?
- How does a good transition usually unfold?
- What does adult follow-up look like for your child's condition?
- What changes between the children's clinic and the adult clinic?
- What do families often get wrong about moving to adult care?
- What should you gather, and what should you ask?
- Common questions about moving to adult haematology care
The short answer
What does moving from paediatric to adult haematology mean?
It means your child's follow-up passes from a children's team to an adult haematology team, usually in the late teenage years. Done well, it is a planned process over several visits, not a single handover letter.
Why it has to happen at all
Children's services are built around parents. Adult services expect the patient to book appointments, describe symptoms and make decisions. A young person who survived leukaemia or lymphoma, or who lives with a long-term blood disorder, still needs regular checks for years. Those checks now sit in a clinic that treats them as an adult.
Why this is a risky moment
The move often comes at the same time as college, a first job or moving to another city. Follow-up visits get missed. Reports stay in a drawer at home. Nobody notices a late effect until it causes trouble. Planning the move early is the simplest way to stop your son or daughter falling through the gap between two clinics.
This page applies to survivors of childhood blood cancer and to young people with long-term blood disorders. The exact timing depends on their condition and on each hospital's rules.The pathway
How does a good transition usually unfold?
Talk about it early
The children's team raises the move well before it happens. Your teenager is told what will change, and why, so it does not come as a surprise at a routine visit.
Build the young person's own skills
They start speaking to the doctor first, seeing the doctor alone for part of the visit, knowing their diagnosis and medicines by name, and booking their own tests.
Prepare the paperwork
A written treatment summary and a follow-up plan are prepared. They list every drug, any radiation or transplant, and which checks are due in the years ahead.
A joint or linked visit
Where possible, the young person meets the adult team with someone from the children's team present, or the two teams speak directly about the case before the first adult appointment.
Check that it stuck
After the first adult visits, someone confirms the young person is attending. A missed appointment is followed up, not quietly closed.
Not sure whether this applies to you?
Ask an oncologistDifferent starting points
What does adult follow-up look like for your child's condition?
The adult team's job depends on what your child was treated for and how. These are common patterns, not a plan for your own child.
Survivor of leukaemia or lymphoma
Treatment is finished. Follow-up now looks for late effects of past treatment rather than for the cancer alone.
Checks often include
- Heart checks after certain chemotherapy drugs
- Hormones, growth and fertility
- Thyroid and bone health after radiation
After a stem cell transplant
These young adults usually need the closest follow-up. Long-term effects on the lungs, eyes, hormones and immune system are watched, and vaccines often need to be given again.
The transplant centre usually stays involved. Ask who is responsible for which checks.Still on treatment at the transition age
Some teenagers are mid-treatment or have relapsed when they reach the adult age. Many centres keep them with the children's team until the current phase ends, so the plan is not disturbed.
Long-term blood disorder
Conditions such as thalassaemia, sickle cell disease or haemophilia need lifelong care. Transfusions, iron checks, crisis plans or clotting factor continue under adult haematology without a break.
Side by side
What changes between the children's clinic and the adult clinic?
Children's clinic
Adult clinic
The doctor talks mainly to parents
The doctor talks mainly to the young person
Parents book visits and carry the file
The young person is expected to book and keep records
Consent is given by parents
Consent is given by the adult patient
Longer visits, often with play or school support
Shorter visits, focused on medical checks
Missed visits are often chased by the team
Missed visits may not be followed up
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Commonly believed
What do families often get wrong about moving to adult care?
"Treatment finished years ago, so follow-up is no longer needed."
Some effects of childhood treatment appear only in adulthood, such as heart, hormone or bone problems. Regular checks find them while they can still be managed. Stopping follow-up because someone feels well is the most common way these problems are missed.
"The adult doctor will already know everything."
Not unless the records travel. Hospitals do not always share files, and a new doctor may see only a referral note. The treatment summary in your young person's own hands is what fills that gap.
"As parents, we should keep handling everything."
Your support still matters. But a young adult who cannot name their own diagnosis or medicines is at risk the day they move away for study or work. Stepping back gradually, while still being there, is what protects them.
"Moving clinics means starting treatment decisions again."
A planned transition carries the existing plan forward. The adult team reviews it, and may add checks suited to an adult, but it should not undo decisions without explaining why.
Before the first adult visit
What should you gather, and what should you ask?
Gather the whole history into one folder, paper or phone, that the young person keeps. Then take a short list of questions to the first adult appointment.
What goes in the folder
The original diagnosis report, including bone marrow and biopsy results. The names of every chemotherapy drug. Details of any radiation, surgery or transplant. Recent blood reports and scans. A list of current medicines and allergies. The written follow-up plan from the children's team, if one exists.
Questions worth asking
Which checks are due, and how often? Who do I call between visits if something feels wrong? Will you speak to my old team if you need details? Which late effects am I at higher risk of, given my treatment? Who handles fertility, heart or hormone checks, and do you refer me?
What this page cannot tell you
It cannot tell you the right age to move, or which checks your own child needs. Those depend on the diagnosis and treatment received. CION's haematology team can review the records, explain the follow-up plan, and coordinate with other specialists where that is needed.
Did you know
Young adults who can tell a new doctor, in their own words, what they were treated for and which drugs they were given are far easier to look after safely. Practising that short summary at home before the first adult visit is one of the most useful things a family can do.
Questions we are asked
Common questions about moving to adult haematology care
At what age does my child move to adult haematology?
It varies by hospital and by condition, and is usually somewhere in the late teenage years. Many teams start preparing well before the actual move. If your child is in the middle of a treatment phase, the move is often delayed until that phase ends. Ask your child's current team what their own policy is.
Can we stay with the children's doctor we trust?
For a while, sometimes. Children's services are not set up for adult health needs such as pregnancy, work stress or adult heart and hormone checks. Staying too long can mean those needs are missed. A gradual move, with the old team available for questions, is usually safer than a sudden one.
My son moved to another city for college. What now?
Ask the current team for a referral letter and treatment summary, and find an adult haematology clinic near where he lives. He should carry copies of his records on his phone. Follow-up visits can often be timed around college holidays if he prefers to keep a clinic closer to home.
Should parents still come to adult appointments?
They can, if the young person wants them there. Adult doctors usually speak to the patient first and may see them alone for part of the visit. That privacy matters for questions about relationships, alcohol, mood or fertility, which many young adults will not raise in front of parents.
What is a survivorship care plan?
It is a written document that sums up the diagnosis, every treatment received, the late effects that treatment can cause, and the checks recommended for the years ahead. Not every hospital provides one automatically. Ask for it before the last children's visit, because it is much harder to rebuild later.
Will adult follow-up be covered by insurance or schemes?
It depends on the scheme and the policy. A young adult may move from a parent's family cover to their own, which can change what is covered. Check the current rules of Aarogyasri, CGHS, ECHS, EHS, PM-JAY or the insurer before the move, because entitlements change.
What if my daughter refuses to attend follow-up?
This is common in young adults who want to put illness behind them. Explain calmly why the checks matter, and let her doctor or a counsellor talk to her directly. Linking visits to things she cares about, such as sports, study or a future family, often helps more than pressure.
Can CION take over my child's adult follow-up?
CION's haematology team sees adults with blood cancers and blood disorders, and can review the full history and set out a follow-up plan. Where a check needs a specialist centre, such as a transplant centre, the team coordinates with it. Bring every record you have to the first visit.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- NICE — Transition from children's to adults' services for young people using health or social care services (NG43)
- National Cancer Institute — Late Effects of Treatment for Childhood Cancer (PDQ)
- American Cancer Society — Children with Cancer: Survivorship
- Leukaemia & Lymphoma Society — Childhood blood cancer survivorship
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Late Effects After Childhood Blood CancerThe checks adult follow-up is looking forGrowth, Puberty and Fertility After Childhood LeukaemiaHormone and fertility questions young adults askRelapsed Childhood LeukaemiaIf the leukaemia comes back around transition agePaediatric Blood CancersThe full guide for parents
Talk to us
Planning your young adult's move to adult care?
Bring the treatment summary and recent reports. CION's haematology team will review the history and set out a follow-up plan. One helpline serves every CION centre.