24 November 2021

We aim to provide members with both general and haematology specific up-to-date COVID-19 information. This advice is for healthcare professionals. Patients looking for further information on their condition are advised to speak to their healthcare providers, who are best placed to answer specific questions. Patients may also be able to get information from their patient support groups, some of them can be found listed here


Media Statement on syndrome of Thrombosis and Thrombocytopenia occurring after coronavirus vaccination

The Expert Haematology Panel has been instrumental in describing this condition and its management and continues to work closely with PHE and regulatory authorities. BSH is working with the EHP to make sure the haematology community is kept up to date with the latest information on this syndrome.  We have received many requests from the media for information and interviews and we continue to do our best to advise and inform wherever possible. However, all our members have responsibilities as NHS clinicians which are their priority roles and if we are unable to respond further, media requests may be redirected to MHRA.


This page will be reviewed every day and updated as necessary. If you would like to add any resources please contact: Saskia@b-s-h.org.uk

 

COVID-19 Vaccination
Third primary COVID-19 vaccine dose for eligible cancer patients (added 24.11.2021)

Letter from NHS England and NHS Improvement on Third primary COVID-19 vaccine dose for eligible cancer patients. 

For attention of GP practices and hospitals: Third vaccine dose for blood cancer patients (added 03.11.2021)

Letter from BCUK: For attention of GP practices and hospitals: Third vaccine dose for blood cancer patients.

Third vaccine dose for patients with Myeloproliferative Neoplasms (MPN) 30.09.2021

For the attention of GP practices and hospitals: Letter from MPN Voice

Updated JCVI guidance for vaccinating immunosuppressed individuals with a third primary dose (Added 09/09/2021)

The updated JCVI guidance for vaccinating immunosuppressed individuals with a third primary dose link is highlighted below

The Joint Committee on Vaccination and Immunisation (JCVI) has issued updated guidance in relation to COVID-19 vaccinations for individuals aged 12 years and over with severe immunosuppression. This letter sets out the actions we are asking systems to take from today to begin vaccinating this group with a third dose as part of their primary vaccination course by 13 September 2021.

Importantly this guidance does not cover all Haematology patient groups and therefore Blood Cancer UK and MPN voice have issued much broader recommendations covering patients with myelodysplasia and myeloproliferative disorders. The link to these is below

Blood Cancer UK

MPN voice

Guidance produced by the Expert Haematology Panel (EHP) focussed on Vaccine induced Thrombosis and Thrombocytopenia (VITT) (last updated 03/09/2021)

Vaccine-induced immune thrombocytopenia and thrombosis: Link to guidance on management provided by the Expert Haematology Panel.

The Expert Haematology Panel comprises specialists in immunohaematology, haemostasis and thrombosis (or blood clotting and immune causes of reduced platelets), who held daily meetings between March and July 2021, to support clinicians managing these patients and learn from new cases. They are in regular communication with the regulators, other UK medical and surgical societies, multidisciplinary groups and international haematology colleagues focussed on this condition.

The meetings continue, now only on Mondays at 2pm, on this link


Media Statement on the syndrome of Thrombosis and Thrombocytopenia occurring after coronavirus vaccination

The Expert Haematology Panel has been instrumental in describing this condition and its management and continues to work closely with PHE and regulatory authorities. BSH is working with the EHP to make sure the haematology community is kept up to date with the latest information on this syndrome.  We have received many requests from the media for information and interviews and we continue to do our best to advise and inform wherever possible. However, all our members have responsibilities as NHS clinicians which are their priority roles and if we are unable to respond further, media requests may be redirected to MHRA

Guidance produced by the UK ITP Forum Working Party on ITP/ITP relapse following Covid-19 vaccination (added 19.08.2021).

Guidance produced by the UK ITP Forum Working Party on ITP/ITP relapse following Covid-19 vaccination.

There is now emerging evidence of a small risk of ITP or ITP relapse following Covid-19 vaccination.  The UK ITP Forum has produced guidance for clinicians managing such cases.  This is a live document subject to updates as more is learnt about the condition.  Additionally, Public Health England  (PHE) are collecting data on this post-vaccine complication in order to better understand it’s clinical history as well as the safety of giving a further Covid-19 vaccine.

Please follow this link to complete the PHE survey

Letter to haematology teams and GPs regarding covid-19 vaccine and blood cancer. Added 11/06/2021

This is a letter that BCUK has written to haematology teams and GPs to highlight that Blood Cancer patients need to know that the covid-19 vaccine may not work for them. 

Haematology triage policy for patients with previous vaccine-induced immune thrombocytopenia and thrombosis (VITT) (updated 14/05/2021)

VITT is a rare disorder occurring after COVID-19 vaccination and leading to blood clots in multiple organ sites including the venous sinuses of the brain. Untreated the risk of death is over 50%. People who have previously had VITT may present with recurrent symptoms. They need to be monitored closely.

This document outlines the Haematology triage policy for patients with previous vaccine-induced immune thrombocytopenia and thrombosis (VITT) 

List of UK Laboratories Offering HIT ELISA testing (updated 14/05/2021)

A list of UK Laboratories Offering HIT ELISA testing can be found here.

COVID-19 vaccine immune thrombosis and thrombocytopenia VITT Information for patients added 24/04/2021

This is a leaflet that can be printed out and given to patients.

COVID-19 vaccine in patients with haematological disorders (Last updated 13/01/2021)

COVID-19 vaccine in patients with haematological disorders

British Society for Haematology

This statement has been produced by the British Society for Haematology and has been reviewed by the Intercollegiate Committee on Haematology, on behalf of the Royal College of Physicians of London and the Royal College of Pathologists. Specialist haematology groups have also contributed

UK Chemotherapy Board Clinician Frequently Asked Questions (FAQs) and guidance on COVID19 vaccine for patients receiving Systemic Anti-Cancer Therapy (Added 12/01/2021)

This document has been produced in response to questions raised by cancer health care professionals relating to the administration of the Pfizer/BioNTech COVID-19 vaccine and the Oxford University/AstraZeneca COVID-19 vaccine in patients receiving SACT.

General Haematology
Guidance on management of ITP (Last Updated 11/01/2021)

The UK ITP Forum, has provided information for adult patients with immune thrombocytopenia in the setting of COVID-19.

Click here to read the document


Practical guidance has been developed for the management of adults with Immune Thrombocytopenia during the COVID-19 pandemic.

Click here to read this guidance.

Reprovisioning Haematology - Last Updated 31/07/2020

Along with many other Specialist Societies, BSH has been working with the Royal College of Physicians to highlight the issues of re-provisioning services in the presence of an ongoing COVID-19 risk.

The following brief summary document has been submitted to RCP and used to inform discussions at a senior level in the Department of Health.

Reprovisioning Haemtology Document 

Diamond Blackfan Anaemia Advice (Last Updated: 04/06/2020)

These documents were made in a collaboration between the Haemoglobinopathy Co-ordinating Centres in England, offering guidance to health professionals working with patients with Diamond Blackfan anaemia (DBA). It has been reviewed and agreed by representatives of the Haemoglobinopathy Co-ordinating Centres in England and the Clinical Reference Group for Haemoglobin disorders and DBA(UK). 

Click the links below to download advice:

NHP COVID-19 Guidance (PDF version)

NHP COVID-19 Guidance: Patients Version (PDF version)

 

Guidance on shielding for Children and Adults with splenectomy or splenic dysfunction during the COVID-19 pandemic (Last updated 06/05/2020

The British Society for Haematology Guidance on shielding for Children and Adults with splenectomy or splenic dysfunction during the COVID-19 pandemic.

Please see our guidance here

Gaucher Disease and COVID-19 Infection (Last Updated 04/05/2020)

The European Gaucher Disease Network, an EHA SWG GD Task Force, have written a response to the current SARS-­‐CoV2 (COVID-19) infection.

Click here to read this response 

BSH Advice on B12 Supplements (Last updated 01/05/2020)

This is the BSH guidance on B12 supplements during COVID pandemic.

Read the guidance here 

Plasmacytoid lymphocytes in COVID-19 (Last updated 30/04/2020)

This is a morphology update article, about a recent case of Plasmacytoid lymphocytes in a patient with COVID-19. It was written by Barbara J. Bain, David Foldes, Richard Hinton and Siamak Arami.

Click here to read this article 

Aplastic Anaemia Guidance (Last Updated 03/04/2020)

King’s College Hospital has released guidance for treating adult aplastic anaemia/bone marrow failure patients during the COVID-19 outbreak.

Click here to read the guidance.


 King's College Hospital has also created a brief data questionnaire for any AA patient in the UK who develops the COVID-19 infection. It is important to capture data in a systematic way on all aplastic anaemia(AA) patients with COVID-19 so that we can learn about the true impact of this virus in this group of patients.

Click here to download this questionnaire

NICE COVID-19 guidelines (Last Updated 23/03/2020)

NICE new guidelines cover the management of patients in critical care, the management of patients who are having kidney dialysis and the management of patients who are receiving systemic anticancer treatments.

It should be noted that due to the need to publish these very rapidly they have not gone through the usual NICE guidance development process.

BJHaem Articles (Last Updated 17/03/2020)

The BJHaem have published open-access articles about COVID-19.

Click the links below to read these articles

Care of haematology patients in a COVID‐19 epidemic

How do we plan hematopoietic cell transplant and cellular therapy with the looming COVID‐19 threat?

Sickle cell and Thalassaemia
Advice to clinicians on risk assessment for severe COVID-19 in patients with haemoglobinopathies and inherited rare anaemias (last updated 28.08.2020
Haemoglobinopathy HCCs advice on recovery COVID-19 26.06.2020

Advice to clinicians on planning for recovery from COVID-19.

This information has been produced following virtual meetings with representatives from the Haemoglobinopathy Co-ordinating Centres (HCCs) for Haemoglobin Disorders, the Clinical Reference Group for Haemoglobin Disorders, the National Haemoglobinopathy Panel, NHS Screening Committee and NHSBT as well as national experts on Sickle Cell Disease, Thalassaemia and Rare Anaemias and patient groups. The topics covered include: 1. Updated shielding advice 2. General advice 3. Inpatient care 4. Day care management 5. Outpatient care and care of long term complications 6. Hydroxycarbamide 7. Annual Reviews 8. Trans-cranial Doppler (TCD) screening 9. Multi-specialist clinics 10. Off-site clinics 11. Management of iron overload 12. Multi-disciplinary meetings 13. Transition 14. Psychology support 15. Community services 16. Education 17. Research 18. Additional advice on management of thalassaemia and rare anaemias 19. Management of patients who have had a Haematopoetic Stem Cell Transplantation /Gene therap

Patient information on COVID-19 in haemoglobinopathy and rare inherited anaemia patients (last updated 18/06/2020)

National Haemoglobinopathy Panel Patient information on COVID-19 in haemoglobinopathy and rare inherited anaemia patients is here.

Haemoglobinopathy Co-ordinating Centres Advice on COVID-19 in patients with Sickle Cell Disease and Thalassaemia (Last Updated 20/04/2020)

A statement has been released from the Haemoglobinopathy Co-ordinating Centres.

Please read the statement here

Iron Chelation Therapy (Last Updated 15/04/2020)

Guidance regarding iron chelation therapy in patients haemoglobin disorders or rare anaemias and cardiac iron overload if unwell with presumed or confirmed COVID-19 infection.

Read the guidance here

Transfusion needs of patients with inherited red cell disorders (Last Updated 15/04/2020)

Guidance on supporting the transfusion needs of patients with inherited red cell disorders during the COVID-19 pandemic in England.

Read this guidance here 

Haemato-Oncology
COVID-19 (coronavirus) advice for patients with Chronic Myeloid Leukaemia receiving tyrosine kinase inhibitor therapy (added 02/09/2021)
EHA/ESMO Clinical Practice Guidelines for the Management of Malignant Lymphoma: Recommendations for the Second Phase of the COVID-19 Pandemic (Last updated 08/02/21)

EHA/ESMO Clinical Practice Guidelines for the Management of Malignant Lymphoma: Recommendations for the Second Phase of the COVID-19 Pandemic

Previously, the European Society of Medical Oncology (ESMO) had established cancer patient management during the coronavirus disease 2019 (COVID-19) pandemic.1 These recommendations should be used as guidance for prioritizing the various aspects of cancer care in order to mitigate the negative effects of the COVID-19 pandemic on the management of cancer patients.

Blood Cancer UK: resources for healthcare professionals working in haemato-oncology (Last Updated: 22/05/2020)

Blood Cancer UK's brand NEW webpages for all healthcare professionals working in haemato-oncology are now live.

 

Topics include:

  

NICE guideline COVID-19 rapid guideline: haematopoietic stem cell transplantation Published on 01 April 2020
Myeloproliferative Neoplasms Advice (Last updated 30th March 2020)

MPN Voice provides information and emotional support to everyone who has been diagnosed with a myeloproliferative neoplasm (MPN) and their families.  Therefore, like many other organizations during the COVID-19 outbreak, MPN Voice are providing people with information issued by the NHS and the Government. 

Click here to read this advice

UK Myeloma Forum (Last Updated 27/03/2020)

The UK Myeloma Forum has released guidance on treating patients in the current COVID-19 pandemic.

Click here to read this guidance.

Chronic Myeloid Leukaemia (Last Updated 23/03/2020)

The National Cancer Research Institute (NCRI) has created COVID-19 (coronavirus) advice for patients with Chronic Myeloid Leukaemia receiving TKI therapy.

Please click here to read this advice

UK/Ireland Paed BMT group guidelines (Last updated 23/03/2020)

The UK/Ireland Paediatric BMT group has created practical guidelines for the prevention and management of COVID-19 in paediatric HSCT patients. 

Please note: These guidelines are purely advisory and should be implemented in the context of advice from Dept of Health, your Trust management and Infection Control teams and will evolve as the situation changes.

Click here to read the guidelines. 

EBMT Recommendations (Last Updated: 18/03/2020)

The European Society for Blood and Marrow Transplantation (EBMT) have issued recommendations for recipients and donors of hematopoietic cells before the beginning of any of the transplant procedures (mobilization, apheresis, marrow harvest, conditioning). These guidelines will be updated when new information is obtained about COVID-19 epidemiology and clinical outcome.

Click here to read current guidelines

To read more from the EBMT, please click link below: 

https://www.ebmt.org/ebmt/news/coronavirus-disease-covid-19-ebmt-recommendations-update-march-16-2020

BSBMTCT Recommendations (Last Updated: 18/03/2020)

The British Society of Blood and Marrow Transplantation and Cellular Therapy(BSBMTCT) have created recommendations for adult patients with COVID-19.

Click here to read the recommendations

Transfusion
General Transfusion advice General Transfusion advice (added 21/06/2021)

During the COVID-19 pandemic, it is important, that patients are able to still receive blood transfusions if and when needs be. This link contains information on current blood and platelets stocks and also other key resources from NHS Blood and Transplant and the National Blood Transfusion Committee included Emergency Blood shortage plans for hospitals.

Please click the link below to access the information:

https://hospital.blood.co.uk/business-continuity/coronavirus-covid-19/


Other Transfusion Resources:

https://www.transfusionguidelines.org/

https://hospital.blood.co.uk/business-continuity/coronavirus-covid-19/

GPP Preoperative patient blood management during the SARS‐CoV‐2 pandemic (added 17/05/2021)

Remote pathways and priorities for care in pandemic times

The COVID‐19 pandemic, caused by the coronavirus SARS‐CoV‐2, has forced examination of much of routine healthcare provision in the UK, and necessitated changes in practice to protect patients from the virus while continuing to deliver high‐quality care for their other health needs. This has been highlighted by the challenges in provision of elective surgical services while SARS‐CoV‐2 remains prevalent in communities. NHS providers have moved from preoperative assessment pathways routinely involving face‐to‐face appointments to remote (telephone, digital or combination) assessments.12 Telehealth‐based solutions provide an innovative option to provide patient care during pandemic times while helping prevent and contain the spread of infection.3 They are also convenient for the patient and medical staff and are likely to become part of routine care in the future. This reduction in face‐to‐face contacts means there is a pressing need to rethink how best to prepare patients for elective surgery, ensuring comprehensive assessment is performed within the limitations imposed by pandemic‐related changes to working practices. It is also an opportunity to review the evidence for best care to evaluate the benefit of certain aspects of what may have become routine practice in consideration of risk balance to the patient.

Click here to read the full guideline.

Haemostasis and Thrombosis