On this page:

Advice for Haematology – Oncology Patients under the care of St George’s Hospital, Tooting during COVID-19 epidemic

COVID-19 is a viral infection caused by a newly emerged form of coronavirus particularly affecting the upper airways and lungs. Everyone in the population needs to be vigilant about minimising the risk of infection, monitoring for signs of infection and reducing risk of transmitting the infection to others. We are aware however that our patients may have particular concerns and needs.

The team here at St George’s Hospital are here to support you during this difficult and anxiety provoking time.  Whilst it will be necessary to make some changes to the way we deliver care, we will be doing our best to continue your usual Haematology care as far as possible during the coming weeks to months.  We are also here along with the rest of the hospital and community health teams to manage and support you if you have concerns related to COVID-19 and your blood disorder.

To help you keep up-to-date with the latest guidance from St George’s Hospital and nationally/internationally, please find some resources to refer to on this webpage.

General NHS Guidance for people with symptoms of COVID-19

The most common symptoms of COVID-19 infection are developing a new continuous cough and/or high fever.

Updated NHS guidance for the general population is found using the link below.  Please consult this if you or one of your household members are unwell with COVID-19 symptoms https://www.nhs.uk/conditions/coronavirus-covid-19/

Shielding

Blood cancers and disorders of the bone marrow can cause the immune system to be weakened.  The exact effects of different blood disorders and their treatment on the risk of contracting COVID-19 infection or developing complications from it are not established.  It is likely however that if your immune system is weak then you could be at a higher risk of becoming ill with COVID-19 infection.

Government guidelines were updated on Monday 23rd March to suggest that some patients should consider ‘shielding’ for 12 weeks depending on the medication regimen they are on.  Details of this advice and further information describing and explaining shielding can be found here

https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

https://www.gov.uk/coronavirus-extremely-vulnerable

Patients who fall into this category should receive a letter from NHSE.  A copy of this letter is attached here. This is important as people considered to be vulnerable can register through the details in this letter to receive extra support as needed.

Haemato-oncology patients thought to be at particular risk are those who:

  • People with cancer who are undergoing active chemotherapy
  • People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
  • People having immunotherapy or other continuing antibody treatments for cancer e.g. Rituximab, Obinutuzumab etc
  • People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors: Ibrutinib, Imatinib, Idelalisib, Nivolumab etc
  • People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs

Other health conditions may also make you more vulnerable to complications from COVID-19 infection.

We are trying to contact patients who are affected by these new guidelines but please do call us and let us know if you think this includes yourself and you haven’t heard from us.

Other health conditions may also make you more vulnerable to complications from COVID-19 infection.

We are trying to contact patients who are affected by these new guidelines but please do call us and let us know if you think this includes yourself and you haven’t heard from us.

Lymphoma patients have been sent this letter here

Employment advice: What shall I do as an employer or employee? Particularly if I am being asked to support someone who is vulnerable according to the new shielding guidance.

If you are shielding and need to be able to discuss this with your employer the following links may be helpful

https://www.gov.uk/government/publications/guidance-to-employers-and-businesses-about-covid-19/covid-19-support-for-businesses

https://111.nhs.uk/isolation-note

https://www.understandinguniversalcredit.gov.uk/coronavirus/

General Advice for Day Unit and Outpatient appointments

We are making efforts to limit hospital visits to minimise the risk of exposure to COVID-19 as much as possible especially for more vulnerable patients.  In some cases we will therefore be contacting patients to make changes to their outpatient appointments.  Where possible, we will be changing face-to-face consultations to telephone (or virtual) consultations (see below).  It may also be necessary to defer some routine follow up or non-urgent appointments.  It is reasonable to query with your individual team whether your hospital visit can be deferred or delivered by telephone.

For most patients on cancer treatment, this will continue for now, but there may be changes in the frequency, dosing or duration of treatment in order to minimise visits to hospital.  This will be communicated to you via your normal clinic appointments or telephone.

Please do not attend the outpatient department or the day unit if you or anyone you have close contact with is unwell and in isolation with COVID-19 symptoms.  Instead please contact:

  1. Ruth Myles Haematology Day Unit (0208 725 1680) or Trevor Howell Day Unit (0208 725 0519)
  1. Clinical Specialist Nurse
  1. Haematology Secretaries to inform us of the situation so we can support you and advise you about rearranging your appointment.

 

If you are unwell please also see the advice below relating to seeking appropriate medical help and advice.

Guidance for patients who are immunosuppressed, or may be neutropenic and feeling unwell

This advice is particularly relevant for the following patients

  • Patients on current anti-cancer therapy or chemotherapy
  • Patients who have had a recent bone marrow transplant (within the last 6 months)
  • Patients who have had a bone marrow transplant and are on immunosuppressive medication, e.g. ciclosporin
  • Patients who have been warned by their haematology team to attend hospital urgently if they develop a fever >38oC or feel unwell

Please click here for what to do if you are feeling unwell

Telephone (or ‘virtual’) clinic appointments

During the coronavirus pandemic the NHS is needing to adapt very quickly in order to stop the spread of the virus. As part of this effort, and in order to reduce the risk to you and medical staff you may be offered a telephone clinic appointment, where a member of the haematology team will contact you at home.  Please see below the following guidance for these telephone clinic appointments:

  • You should receive blood forms for blood tests ahead of your appointment in the post if these are required.
  • Please have these blood tests done preferably at The Nelson Medical Practice, Queen Mary’s Hospital Roehampton, your GP practice (if samples are processed at Croydon University Hospital, Kingston Hospital, St George’s Hospital). Otherwise please attend St George’s Hospital phlebotomy department or Haematology Oncology Outpatients (HOOP)
  • The phone call will last approximately 10-15 minutes. Please be aware that the phone calls from the hospital appear as a private number so if you are called from a private number around the time of your appointment please answer. Please also ensure there is no block on your phone for ‘No caller ID’ calls.
  • Please be available for 30 minutes either side of your appointment
  • We will try and call you 3 times. If you do not answer after 3 attempts we will have to defer your appointment.
  • If you are not sure that we have accurate contact information for you then please contact our secretaries to update this.
  • Please find a place where you are happy to talk about your medical condition.
  • During the consultation, we will aim to tell you if your next appointment will be a telephone/virtual consultation or face-to-face.
  • We will send you the details of your next appointment and any blood forms for this appointment to you in the post.

 

Useful web-based resources

A number of resources are available providing specific and more detailed information and guidance.  We have tried to compile some of these below.

General Information

Bloodwise Charity: Coronavirus and blood cancer

https://bloodwise.org.uk/blog/coronavirus-and-blood-cancer

Macmillan Cancer Support: Cancer and coronavirus

https://www.macmillan.org.uk/cancer-information-and-support/get-help/physical-help/cancer-and-coronavirus

Cancer charities: One Cancer Voice Guidance

https://www.myeloma.org.uk/wp-content/uploads/2020/03/One-Cancer-Voice-advice-on-coronavirus-for-people-with-cancer-V2b.pdf

Myeloma

MyelomaUK: COVID-19 Information Hub

https://www.myeloma.org.uk/news-and-stories/covid-19-information-hub/

Myeloproliferative neoplasms (MPNs) including essential thrombocythaemia (ET), polycythaemia vera (PV) and myelofibrosis

MPN Voice: Coronavirus (COVID-19) Advice and Information

https://www.mpnvoice.org.uk/coronavirus-covid-19-advice-and-information/coronavirus_covid_19_advice_for_people_with_mpns.aspx

Chronic Myeloid Leukaemia (CML)

https://cmlsupport.org.uk/article/guidance-icmlf-regarding-covid-19

 Myelodysplasia / myelodysplastic syndrome (MDS)

MDS Foundation: Coronavirus (COVID-19) and MDS

https://www.mds-foundation.org/mds-and-coronavirus-covid-19/

Chronic Lymphocytic Leukaemia (CLL)

CLL Support: Lastest advice on COVID-19

https://www.cllsupport.org.uk/latest-advice-on-covid-19/

Lymphoma

https://lymphoma-action.org.uk/lymphoma-action-statement-coronavirus-covid-19

Bone marrow Transplant

Anthony Nolan: Coronavirus and your stem cell transplant

https://www.anthonynolan.org/patients-and-families/understanding-stem-cell-transplants/coronavirus-and-your-stem-cell-transplant

Relevant contact details

Within working hours:

Clinical Nurse Specialists

 

Haematology Day Unit: 0208 725 1680, Working hours: Monday-Friday 9am-6pm

Trevor Howell Day Unit: 0208 725 0519, Working hours: Monday-Friday 9am-6pm

Acute Oncology Service (available to Lymphoma patients under Drs Pettengell/Peng): 0783 114 7653, Working hours: Monday-Friday 9am-5pm


Outside of working hours:

Haematology Registrar On-call (available via switch board, 0208 672 1255)

 

Haematological cancers are cancers of the blood and lymphatic system. These include leukaemias, lymphomas and myeloma.

The Haematology-Oncology Unit offers a comprehensive diagnostic and treatment service for patients with a wide variety of blood cancers; this includes bone marrow transplantation. The Lymphoma clinic also offers a one-stop referral pathway for the diagnosis of lymphoma.

There is a robust research portfolio which gives our patients access to innovative treatments.

We provide a number of clinical services including:

Acute Leukaemia Service
Dr Matthias Klammer , Dr Mickey Koh, Dr Fenella Willis, Dr Yasmin Reyal; Dr Theodora Vatopoulou
CNS: Joanne Murfett

Myeloid Malignancies Service
Dr Yasmin Reyal, Dr Matthias Klammer, Dr Mickey Koh, Dr Fenella Willis, Dr Theodora Vatopoulou
CNS: Joanne Murfett

Lymphoma Service
Dr Ruth Pettengell, Dr Ying Ying Peng
CNS: Beverley Wilson

Myeloma and Plasma Cell Dyscrasia Service
Dr Fenella Willis, Dr Yasmin Reyal, Dr Theodora Vatopoulou
CNS: Currently vacant. To be filled Feb 2020

Blood and Marrow Transplant (BMT) Service
Dr Mickey Koh; Dr Matthias Klammer; Dr Dara Qadir
CNS: Michaela Mayhew; Jane Bowley

Teenage and Young Adult Cancer (TYAC) Service
Dr Ruth Pettengell
CNS: Claire Fowler

Location

Haematology and Oncology Outpatients, Ground Floor , St James Wing, St George’s Hospital