Healthcare professionals and patients in a clinical setting

Latest clinical guidelines

To help you put in place the best standards of care for your patients. From COVID-19 vaccinations, to late effects practice guidelines.

COVID-19 vaccine: re-vaccination after transplant

As per JCVI guidance, all patients who receive their COVID-19 vaccination before their stem cell transplant or CAR-T therapy should be re-vaccinated with all primary doses and booster doses they are eligible for.

The timing of re-vaccination should be in line with the British Society of Blood and Marrow Transplantation recommendations i.e., 3-6 months after transplant or CAR-T.

You may find this template useful to arrange re-vaccination for your patient after their transplant or CAR-T treatment. It has been developed with NHS England. Clinicians based in Scotland, Wales or Northern Ireland may need to adapt it for use locally.

Links to COVID-19 guidance

Late Effects Practice Guidelines

Our Late Effects Practice Guidelines (LEPG) have been created for transplant and non-transplant healthcare professionals. They:

  • were developed by a working group and advisory group of transplant healthcare professionals, GPs and patient representatives, following research on current practice and need.
  • apply to both autologous and allogeneic stem cell transplants unless otherwise stated.

Cognition

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Patient-reported changes in cognition after stem cell transplant (SCT) is common but there is limited understanding by transplant healthcare professionals or research into the management of symptoms.

The LEPG working group acknowledges that the guidelines are limited but see this as a first step to encouraging discussion with patients and documenting interventions.

There are plans for further research into the use of an appropriate cognition tool.

Assessment

  • Discuss the potential effects of SCT treatment on cognition as early as possible, ideally pre-transplant.
  • Consider using a cognition screening tool for baseline assessment.
  • Routinely discuss/re-assess at 6 months, 1 year and annually at a minimum.

Management

  • Provide information on the effects of stem cell transplant on cognition and advise on intervention and strategies that will improve symptoms.
  • Plan and document the interventions and strategies that will help the improvement and management of cognition.
  • Consider the effects of fatigue, mental wellbeing and lifestyle on cognition.
  • Consider referral to a cognitive rehabilitation service (if available), occupational therapist or neuropsychologist.

Practical Tools

Recovery Summaries

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What is a recovery summary?

An Anthony Nolan recovery summary can be used to summarise a patient's recovery after transplant.

We recommend that this begins at six months post-transplant and is repeated at one year. It can then be used annually and can be used to follow up late effects of treatment.

As well as assessing physical recovery, a recovery summary will promote a holistic assessment, encouraging conversations around mental wellbeing, relationships, sexual health, finance and work.

If you are completing a recovery summary...

We know that each transplant centre will do things differently, so the recovery summaries can be used as a template.

You can download the recovery summary as a PDF and edit it onscreen. Or you can print it out and complete it by hand.

This recovery summary has been developed using well established international guidelines for caring for post-transplant patients. They have been user tested by patients and peer reviewed by transplant specialists.

Psychological Assessment Guidance in HSCT (adults)

Guidelines for the role of psychological specialists in the assessment of adults undergoing Haematopoietic Stem Cell Transplantation.

These guidelines have been developed by a working group within the UK Haematopoietic Stem Cell Transplant (HSCT) Psychological Professionals Special Interest Group and are endorsed by the Association of Clinical Psychologists and Anthony Nolan.

The guidelines are aimed at registered psychological specialists at levels 3 and 4 (as specified in the NICE 2004 criteria), working within Haematopoietic Stem Cell Transplant (HSCT) centres. This document provides information and recommendations to facilitate psychological professionals who work as part of multidisciplinary teams (MDT) in HSCT.

The guidance aids HSCT centres in the development and implementation of clear pathways, with regards to pre-transplant psychological consultation and support for adults identified as suitable for HSCT, it also aims to inform transplant pathways and local commissioning arrangements in relation to psychological assessment and support within this specialist area.

Patient Recovery Summaries

An Anthony Nolan recovery summary can be used to summarise recovery after transplant.

We recommend that this begins at six months post-transplant and is repeated at one year. It can then be used annually and can be used to follow up late effects of treatment.

As well as assessing physical recovery, a recovery summary will promote a holistic assessment, encouraging conversations around mental wellbeing, relationships, sexual health, finance and work.

A full guide is below, plus recovery summaries that you can print & complete, or edit as a PDF.

Our guidelines are updated as and when relevant. If you have any questions, please email lead.nurse@anthonynolan.org.

Information first published: 25/04/2023

Last update: 15/04/2024