Biologically, a child is a human being between the stages of birth and puberty. The legal definition of child generally refers to a minor, otherwise known as a person younger than the age of majority (Oxford University Press (Accessed 5th January 2013)). The ability to cure children with cancer has radically improved over the recent decades. Today, more than 80% of children with cancer are cured of their disease (Franklin 2014). This incredible achievement is one of the greatest triumphs in the history of medicine and is the result of numerous factors, including developments in paediatric haematopoietic stem cell transplantation (HSCT). Treatment advances for the sick child have been accomplished in various cancer treatments including chemotherapy, surgery, radiotherapy and HSCT. Whilst these therapies have vastly improved outcomes in childhood cancers, there remains scope for further improvement. Keywords HSCT • Paediatric 8.1.1 The Role of EBMT in Paediatric HSCT Changes in HSCT approaches are responsible for progress in this particular area. The role and status of transplantation have evolved. It is no longer considered a salvage therapy for patients in desperate circumstances but is now the treatment of choice for many diseases. The history of paediatric HSCT in Europe began in Poland in 1949 (Raszek-Rosenbusch), with therapeutic transfusion of bone marrow in children with leukaemia and other blood diseases. Subsequent developments in paediatric HSCT were driven on by the creation in 1974, of

Background: The COVID-19 pandemic led to systemic change within healthcare settings. Policies were enacted in order to protect vulnerable cancer patients, meaning the landscape of service provision was significantly altered. Objective: To evaluate the experiences of young cancer patients and their caregivers during the first wave of the pandemic, to inform future service provision. Method: Semistructured interviews were conducted via video software with a cohort of teenage and young adult (AYA) patients (n = 8), as well as caregivers (n = 4). Interviews were analyzed using Framework Analysis. Results: AYA patients and caregivers highlighted areas of care which remained unchanged throughout the pandemic (treatment, communication, safety, and kindness) and areas impacted by the pandemic (visitation, inconsistent rules, lack of resources, and staff conduct). Conclusions: The pandemic was challenging for patients and caregivers. Issues such as extended periods of isolation and inconsistent rules have heavily impacted the wellbeing of AYA patients and their caregivers, and may possibly have further impacts on them. Implications for Practice: Patients and caregivers who received care during the pandemic may need further support. Isolation of patients should be avoided where possible, and rules should be consistent for all AYA patients. Staff should be reminded of the impact their conduct can have on patients and caregivers, both positively and negatively. Foundational: There is little currently known about the long term impact of having cancer during COVID-19 for the AYA cohort. This report makes suggestions on areas which will need attention.

Whilst the basic principles of HSCT remain the same, regardless of the age of the patient, there are a number of important additional considerations relating to transplantation of our younger and older patients and those of adolescent age. The principles outlined in this chapter serve as a valuable reminder supporting age-appropriate patient-centred care delivery. This chapter initially focuses on transplanting the child and its physiological and psycho-social aspects. Subsequently, the nursing challenges in the AYA population will be addressed. This chapter ends with considerations for treatment and care for the older adult.