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 email [email protected].
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?
The charity Blood Cancer UK has issued guidance about the coronavirus COVID-19 aimed at blood cancer patients, setting out those at greatest risk and what measures should be taken.
Many haematology patients who have blood cancers suffer from suppressed immune systems. The World Health Organisation recently declared the COVID-19 outbreak a pandemic, urging countries to take all possible steps to limit the spread of the virus.
Blood Cancer UK advises that healthcare professionals can help reduce the risk to blood cancer patients may be able to conduct appointments remotely if possible, such as over the telephone or a video call. This will help avoid bringing patients to crowded clinics during the outbreak.This advice includes that at-risk patients and their carers should avoid crowded places. They should distance themselves from places where there might be other people with the virus, the charity says.
Patients do not need to isolate themselves at home – as activities such as walking in a park should not pose a risk, according to chief executive Gemma Peters.
She warns that hospitals are places where patients are at greatest risk. Phone and video appointments should be used where possible – and blood tests can be scheduled away from hospital sites.
Gemma Peters says that patients who need to go to hospital for treatment should attend – and the teams caring for them will take every possible precaution.
She said: “Things with blood cancer are a little bit different as more people are more likely to be immunosuppressed than in other kinds of cancer.”
People with weakened immune systems who are at increased risk of complications from coronavirus include:
- People having chemotherapy, or who’ve had chemotherapy in the last 3 months;
- People having immunotherapy or other antibody treatments for cancer;
- People having targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors;
- People who’ve had a bone marrow or stem cell transplant in the last 6 months, or who are still taking immunosuppression drugs; and
- People with some types of blood cancer which affect the immune system, such as chronic leukaemia, lymphoma or myeloma, even if no treatment is being given.
The British Society of Blood and Marrow Transplantation and Cellular Therapy(BSBMTCT) have created recommendations for adult patients with COVID-19.
The National Cancer Research Institute (NCRI) has created COVID-19 (coronavirus) advice for patients with Chronic Myeloid Leukaemia receiving TKI therapy.
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)
The BSH Guidelines committee has produced specific information for haematologists that should be used as an adjunct to the overarching advice from Public Health England.
Please click the links below to read:
DIC Score in COVID-19 Pneumonia
PCR Positivity for COVID-19 in blood samples
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:
The UK ITP Forum, has provided information for adult patients with immune thrombocytopenia in the setting of the COVID-19 .
The BSH Haemostasis and Thrombosis Task Force has created guidance on INR testing for out-patients on warfarin during COVID-19 restrictions.
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. In addition to this they issued an update on 19th March 2020 with information for people with MPNs, which represents the collective opinions of MPN clinicians.
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.
The haemoglobinopathy co-ordinating centres have developed advice for the management of COVID-19 in patients with Sickle Cell Disease and Thalassaemia.
This is the guidance for managing thrombotic risk, coagulopathy and DIC in patients with COVID-19.
Click here to read the guidance
The International Society on Thrombosis and Haemostasis (ISTH) has also released interim guidance on recognition and management of coagulopathy in COVID-19.
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/
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.
The UK Myeloma Forum has released guidance on treating patients in the current COVID-19 pandemic.
Thrombosis UK has established a psychology therapy and consultancy service specifically for VITT patients.
This is led by a clinical psychologist (Prof Paul Bennett) who has substantial experience in the treatment of individuals experiencing adverse psychological reactions to significant health challenges. Although operating virtually (via zoom), this will provide live therapy sessions, email support, and consultations as appropriate.
All patients referred to the service will have an initial ‘live’ consultation and follow-up support as appropriate.
More information can be found here.
This page covers what we know so far about covid vaccine effectiveness in people with different types of blood cancer, and what Blood Cancer UK are doing in this area.
Additional provision of support for Vaccine-Induced Immune Thrombocytopenia and Thrombosis (VITT) patients leaflet provided by Thrombosis UK
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.
An information sheet for patients with Immune Thrombocytopenia (ITP) scheduled for Covid-19 vaccination.
Letter from NHS England and NHS Improvement on Third primary COVID-19 vaccine dose for eligible cancer patients.
Letter from BCUK: For attention of GP practices and hospitals: Third vaccine dose for blood cancer patients.
For the attention of GP practices and hospitals: Letter from MPN Voice
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
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
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.
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)
A list of UK Laboratories Offering HIT ELISA testing can be found here.
This is a leaflet that can be printed out and given to patients.
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
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.
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
The Government has announced changes to its policy on coronavirus testing in England. Patients eligible for COVID-19 treatments through a COVID Medicines Delivery Unit (CMDU) will now need to use a Lateral Flow Test, which will be supplied to them by UKHSA, for use at home if they have symptoms of COVID-19.
Key information you need to know can be found here.
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.
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)
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
The European Gaucher Disease Network, an EHA SWG GD Task Force, have written a response to the current SARS-‐CoV2 (COVID-19) infection.
This is the BSH guidance on B12 supplements during COVID pandemic.
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.
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.
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.
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?
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
National Haemoglobinopathy Panel Patient information on COVID-19 in haemoglobinopathy and rare inherited anaemia patients is here.
A statement has been released from the Haemoglobinopathy Co-ordinating Centres.
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.
The haemoglobinopathy co-ordinating centres have developed advice for the management of COVID-19 in patients with Sickle Cell Disease and Thalassaemia.
Guidance on supporting the transfusion needs of patients with inherited red cell disorders during the COVID-19 pandemic in England.
A multi-stakeholder coalition consisting of representatives from the global patient advocacy and clinical community has formed the International COVID-19 Blood Cancer Coalition (ICBCC) to address the specific impact of the pandemic on immunocompromised blood cancer patients (both acute and
chronic), like those living with Chronic Lymphocytic Leukemia (CLL), and to recommend solutions and
actions to mitigate those risks.
BSH has endorsed their PATIENT IMPACT STATEMENT AND RECOMMENDATIONS: Protecting immunocompromised blood cancer patients during the COVID-19 pandemic which can be found here.
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.
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.
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.
Blood Cancer UK's brand NEW webpages for all healthcare professionals working in haemato-oncology are now live.
Topics include:
- Coronavirus resources for healthcare professionals
- Guidance for managing haemato-oncology patients
- Learning resources for those new to haematology
- Managing healthcare professionals’ health and well-being
- Facilitating conversations around Advance Care Plannng
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.
The UK Myeloma Forum has released guidance on treating patients in the current COVID-19 pandemic.
The National Cancer Research Institute (NCRI) has created COVID-19 (coronavirus) advice for patients with Chronic Myeloid Leukaemia receiving TKI therapy.
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.
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:
The British Society of Blood and Marrow Transplantation and Cellular Therapy(BSBMTCT) have created recommendations for adult patients with COVID-19.
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/
The British Society of Blood and Marrow Transplantation and Cellular Therapy(BSBMTCT) have created recommendations for adult patients with COVID-19.
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.1, 2 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.
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:
The NHS is now leading a major new programme, on behalf of the Government, to collect convalescent plasma from people who have recovered from COVID-19.
Click the links below to read more about this:
https://www.nhsbt.nhs.uk/covid-19-research/documents-and-downloads/
https://hospital.blood.co.uk/ (click on convalescent plasma tab)