February 2021 – Issue 2

Dear BSBMTCT member,

We hope all is well with you.

We will begin the February newsletter with exactly the same phrase as the January….“Undoubtedly, Covid-19 remains our number 1 priority at present.”

However, there has been tangible progress on a number of fronts, which hopefully is all part of a process where the current wave of the pandemic will decline into a persisting but low level ‘endemic’ seasonal viral infection, more manageable with new ways of working in our clinical environments and living in society in general. Of course, vaccination has been an important part of progress and, as we write, over 18 million have now received their vaccinations in the UK. However, we still have important issues to address in our clinically extremely vulnerable patient population.

We are very pleased to report that BSBMTCT are part of this great effort, alongside other great initiatives within our UK haemato-oncology and EBMT communities. Our BSBMTCT COVID-19 guidelines continue to be updated, now with monthly updates of the vaccination guidelines developed by the Vaccination Sub-committee involving experts in vaccinology, immunology, as well as a bedrock of BSBMTCT leaders, with the latest update published on February 18th on the website https://bsbmtct.org/bsbmtct-and-covid/

We are also very pleased that both general and vaccination BSBMTCT guidelines now feed as a ‘living document’ into the updated NICE guideline NG164 on COVID in HSCT published on February 10th which continue to be an important ‘plain English’ route to highlighting implementing and resourcing changes with local and national NHS colleagues outside our speciality https://www.nice.org.uk/guidance/ng164

Through the hard work of Paul Miller and Thushan de Silva, the BSBMTCT has also been able to contribute an additional HSCT and CART cohort to the national multi-speciality OCTAVE Study of immune response post COVID, which is rapidly becoming activated within the core and other IMPACT centres in the next few weeks.

In the meantime, on a routine level we do not know whether transplant recipients will respond to the vaccines currently available and it would be prudent to continue recommending ‘viral avoidance’ behaviour. Many patients are asking ‘am I immune after the vaccination’ and as yet we have no reliable way to answer that question. Post-vaccination serology may help but as yet this is not being routinely recommended or performed. A reasonable question is whether we should test and we’d welcome feedback from your centre.

Also please continue to report to EBMTs Prospective survey on impact of COVID-19 on HSCT recipients and patients treated with CAR-T cells. There are updated forms now available https://www.ebmt.org/ebmt/news/prospective-survey-impact-covid-19-stem-cell-transplant-recipients-and-patients-treated

We thank Henny Braund and Anthony Nolan for bringing together our community and NHSE colleagues in now routine ‘Monday afternoon’ TEAMS meetings for vital information exchange across the many parts of the country, which often feeds into other initiatives and action via the CRG. In recovery and restoration planning the regional Operational Delivery Networks or ‘clusters’ will be as important as ever supporting the ‘mutual aid’ arrangements locally.

 

Otherwise, there remains much on the ‘to do’ list; some imminent issues, some still in development…

  • Just what we didn’t need at this time – a supply with alemtuzumab/Campath-1H, which forms a cornerstone in so many of our transplant regimens. As many of you will be aware, we have been actively working with the CRG, NHS pharmacists and all necessary agencies to find a way through – both in the short term, and also for a longer term solution.
  • Also imminently, please expect further updates from the EBMT/JACIE outcomes benchmarking system, still in pilot phase, but evolving into a sophisticated risk adapted system. Of those centres that were expecting to receive the clinical outcomes results but have not yet received them please contact the JACIE office at benchmarking@ebmt.org as there have been problems with the communication process.
  • The BSBMTCT Registry are preparing for the 12th Edition of the BSBMTCT Executive Summary of Transplant & Cellular Therapy Outcomes in UK and ROI. We are looking at transplants performed between 2014 and 2019. The deadline to ensure all registrations and follow ups are included is Thursday 1st April 2021.
  • In the next year we will also be looking for replacements for a few of our Executive Committee who will have reached the end of their term of office. We will inform you when these opportunities become available.
  • As mentioned in the previous bulletin a number of other topics will be addressed in the coming year; workforce, revised BMT indications, delivering accreditation remotely, modernising internal workings of the society and strengthening links with our key partners. All ongoing along with various meetings and events for your diary….
  • We will be holding the Annual Scientific Meeting on May 12th, 2021 and the Education Day on November 3rd 2021. The first will definitely be ‘virtual’ – the programme is now available and the registration is open https://bsbmtct.org/events/bsbmtct-scientific-day/. Who knows where we’ll be towards the end of the year – however, we will find a way to bring everyone together.
  • There will be another virtual EBMT Annual Meeting from 14th to 17th March which will be a good source of clinical and scientific information, which you can watch from the comfort of your own home/office, of course with the very best efforts to ‘network’ as can be achieved virtually. Hopefully we’ll be able to meet in Prague next year (and eventually in Glasgow!).

 

We try to round off with a dedication to a fantastic colleague in our bulletin each month. This month we specially acknowledge Professor Judith Marsh, who retires this month, for her longstanding and inspirational leadership of the field of aplastic anaemia. Judith has achieved so much during her career – clinically and scientifically – for the immense benefit of patients and colleagues around the UK and worldwide. We will miss you, Judith!

We hope that you all stay safe and well, mentally and physically, we know that the last year has worn many of us down (incredibly we’ve kept going) and we’ve still got many challenging months to come. We hope that we can all maintain the high levels of compassion and support to each other, our colleagues and our patients and their families. The BSBMTCT will do its best to maintain high levels of support and direction for our community, help each other deliver our treatments in our vulnerable patient population as the pandemic moves into the endemic phase.

Our very best wishes,

John Snowden, President
Kim Orchard, Past President
Fiona Dignan, Secretary
Debbie Richardson, Treasurer
Eduardo Olavarria, President Elect
Julia Lee, Head of Registry

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