Guidance

Update information

Update information

28 September 2023: We have removed and amended recommendations throughout the guideline to reflect changes to current best practice and service organisation, which have been adapted over time throughout the pandemic.

Recommendation 1.2 was changed to better reflect current practice. Recommendation 1.4 was changed to advise following local guidance for infection prevention and control.

Recommendations 2.4 and 2.5 were changed to reflect current practice of using fresh cells routinely and cryopreserved cells only in exceptional circumstances.

We removed recommendations 2.8 and 2.9 on donor testing, and made changes to recommendations 2.2, 2.7 and 2.11 to 2.13 to reflect current practice.

We removed recommendations in section 4 on service provision and organisation that are covered by external guidance or have become embedded in routine practice during the pandemic.

20 July 2022: We have removed, relocated and amended recommendations throughout the guideline to reflect changes to current best practice and service organisation, which have been adapted over time thoroughout the pandemic. In some sections, we have removed recommendations and link instead to current national and international guidelines. Previous sections on patients with new symptoms of COVID-19; supporting staff, including staff who are isolating; and prioritising treatment have been withdrawn because changes to processes and care have become embedded in routine practice during the pandemic.

The following recommendations have been updated to better reflect current best practice:

  • Recommendation 2.3 was changed to reflect that decisions about deferring allogeneic HSCT should be based on an individualised assessment.

  • Recommendations 2.4 and 2.5 were amended to remove the requirement to cryopreserve all donations.

  • Recommendations 2.8 and 2.9 were updated to reflect current best practice for testing donors for COVID-19 when fresh or cryopreserved cells are being taken.

  • Recommendations on donors with COVID-19 were updated to give clear, separate advice for HPC apheresis and mononuculear cell donors and for HPC marrow donors on deferring donations (recommendations 2.11 and 2.12) and current best practice on what to do if a donor tests positive at a late stage (recommendation 2.13)

  • Recommendation 4.10 was amended to reflect the need for staff to follow local policies for return to work following COVID-19, which acknowledges that different transplant units may have different local policies.

22 July 2021: We made changes on testing patients for viruses, including SARS‑CoV-2, to note that a polymerase chain reaction (PCR) test should be used as the gold stardard (recommendation 2.2).

10 February 2021: We amended our recommendations on when to defer donations and HSCT for donors and recipients pre-transplant, in line with updated BSBMTCT guidance. We also updated our guidance for staff who are self-isolating, and added a recommendation on vaccination.

29 July 2020: We made changes in recommendations on:

  • advice for patients to limit the number of family members who attend appointments (recommendation 1.2) and explaining measures to limit infection risk (recommendation 1.3)

  • advice for patients on minimising risk of respiratory infections before transplantation (recommendation 2.1)

  • testing for respiratory viruses before transplantation (recommendation 2.2)

  • risk assessments for ambulatory transplant pathways (recommendation 4.1)

  • what to do when a centre is temporarily closed (recommendation 4.4)

  • assessing the viability of cryopreserved stem cells (recommendation 4.7)

  • pathways and accommodations for patients who test positive for COVID-19 (recommendation 4.9).

We have also removed recommendations that advised deferring most autologous and allogeneic haematopoietic stem cell transplants, and deferring transplants if further treatment or immunosuppression would put them at more risk from COVID-19 in the community. This is to reflect changes in the risk of infection and the capacity in services.

Minor changes since publication

1 June 2020: We amended a cross reference to link to UK government guidance on managing exposure to COVID-19 in hospital settings. We also aligned the recommendations with current government advice on social distancing.

ISBN: 978-1-4731-5421-6