The BSH Guidelines Official Podcast

Audio commentary by Dr George Follows.

British Society for Haematology Annual Scientific Meeting Guidelines Session 2022

Dr Suzy Morton on the Good Practice Paper Cytomegalovirus serological testing in potential allogeneic haematopoietic stem cell transplant recipients.

Dr Suzy Morton is a Consultant in clinical haematology and blood transfusion at the Queen Elizabeth Hospital, University Hospitals Birmingham and NHS Blood and Transplant. She is the transfusion representative on the West Midlands Haematology Specialty Training Committee and the educational lead for haematology SpRs at QEHB. Suzy is a transfusion representative on the BSH Education committee.

British Society for Haematology Annual Scientific Meeting Guidelines Session 2022

Dr Katie Hands presents on the Good Practice Paper Preoperative patient blood management during the SARS-CoV-2 pandemic. 

Katie Hands is a Consultant Haematologist with the Scottish National Blood Transfusion Service (SNBTS) based at Ninewells Hospital, Dundee. She is a member of the British Society for Haematology Transfusion Task Force and is involved in the preparation of evidence-based guidelines relating to all aspects of blood transfusion in the United Kingdom. 

British Society for Haematology Annual Scientific Meeting Guidelines Session 2022

Dr Austin Kulasekararaj presents on the Myelodysplastic syndromes covering the BSH Guidelines on the diagnosis and prognosis of adult myelodysplastic syndromes and Guidelines on the management of adult myelodysplastic syndromes.

Dr Austin Kulasekararaj is a Consultant Haematologist at the King's College Hospital London. His special interests are adult myelodysplastic syndromes, acute leukaemia and aplastic anaemia.

British Society for Haematology Annual Scientific Meeting Guidelines Session 2022

Dr Dima ElSharkawi presents the Guideline on the Diagnosis and Management of Waldenstrom Macroglobulinaemia.

Dr Dima El-Sharkawi is a Consultant Haematologist and part of the haematological malignancy diagnostic services at the Royal Marsden NHS Foundation Trust. She is also a Trustee for the UK Charity for Waldenström macroglobulinaemia (WMUK). Dr El-Sharkawi's special interests are in CLL, rare leukaemias and lymphomas including Waldenström macroglobulinaemia.

Dr Nilima Parry Jones and Dr Renata Walewska present a podcast on the Guideline for the treatment of chronic lymphocytic leukaemia

Both Dr Parry Jones and Dr Walewska discuss the guideline in three main parts:

1) Choice of treatment for CLL in front line and relapsed settings

2) Impact to immune dysregulation in respect of anti-microbial prophylaxis and vaccination

3) Challenges of the Covid pandemic, the evolving evidence on vaccine response, treatment of patients with Covid and antiviral and monoclonal antibodies 

Dr Nilima Parry-Jones is a Consultant Haematologist at the Aneurin Bevan Local Health, Wales and an executive member of the UK CLL Forum. She is the Chair of the BSH Haematology Oncology Task Force.

Dr Renata Walewska is a Consultant Haematologist at the Royal Bournemouth Hospital and Chair of the UK CLL Forum.

Dr Noemi Roy and Dr Roberta Russo present a podcast on the The use of next-generation sequencing in the diagnosis of rare inherited anaemias: A Joint BSH/EHA Good Practice Paper

Dr Roy and Dr Russo discuss the good practice paper in three main parts:

1) Focus on rare anaemias: ( Diamond-Blackfan Anaemia, Congenial dyserythropoietic anaemia (CDA), Sideroblastic anaemia and Red cell membrane/cation leaking and enzyme disorders

2) Next generation sequencing (NGS)

3) How and why we need to interpret genetic variants carefully 

The use of next-generation sequencing (NGS) in the diagnosis of rare inherited anaemias is increasingly common, as evidenced by a growing number of publications describing its clinical utility.^1-6 Excluding disorders of globin synthesis, rare anaemias include Diamond–Blackfan anaemia (DBA), congenital dyserythropoietic anaemias (CDA), congenital sideroblastic anaemias (CSA) and disorders of red cell membrane and enzymes. Other forms of genetic anaemias can also be considered while establishing NGS panels, in particular genetic syndromes where anaemia comprises one of the constellation of symptoms.

Dr Noemi Roy is a Consultant Haematologist at Oxford University Hospitals NSH Foundation Trust and honorary senior clinical lecturer in haematology at the University of Oxford. She is a BSH General Haematology Task Force member and Chair for the Guidelines Executive committee for the European Hematology Association. She is the rare anaemia representative at the National Haemoglobinopathy Panel. Her main interests are haemoglobinopathies and rare inherited anaemias, and in particular the genetic investigation of inherited anaemias, including whole genome sequencing.

Dr Roberta Russo is an assistant professor in medical genetics at the University of Naples "Federico II". She has dealt with the study of the genetics of rare disorders, particularly hereditary anaemias, since 2008. Her main interest was the study of Congenital Dyserythropoietic Anaemias (CDAs), mainly CDA type II, genetics and genomics of red cell anaemias and blood cell defects . She contributed first hand to the identification of the causative genes of rare anaemias. Subsequently, she became one of the leading scientists for the genetics and epidemiology of CDAs. Since 2015, she has been dealing with the application of next generation sequencing to the clinical and medical definition of patients affected by this conditions. In 2011, she won the Young Investigator Award by the American Journal of Hematology for her study on the epidemiology of this disorder.

Professor Peter Chiodini present a podcast on the Guidelines for the laboratory diagnosis of malaria. 

Professor Chiodini will discuss the guideline by highlighting points which will be relevant to your practice, giving pointers to where one may need to seek more information and how one may be able to access help in one would like to increase expertise in this critical area.

Professor Chiodini begins with explaining why do we need this guideline with the basics of the malaria problem and why we need to continue excellence in diagnosis.

Highlights include:

1) Malaria microscopy

2) Diagnosis of malaria by rapid diagnostic tests

3) Malaria molecular methods

The range of supplementary tests available for diagnosing malaria has continued to expand. Despite this, carefully examined thick and thin blood films remain an essential part of the process. This guideline updates the previous 2013 British Society for Haematology Guideline for the Laboratory Diagnosis of Malaria.

Professor Peter Chiodini is a Consultant Parasitologist at the Hospital for Tropical Diseases, Honorary Professor at the London School of Hygiene & Tropical Medicine, Honorary Clinical Professor at University College London and Director of the Public Health England (PHE) Malaria Reference Laboratory and the PHE Parasitology Reference Laboratory. He organizes the UK National External Quality Assessment Schemes for Parasitology, is a member of the PHE Advisory Committee on Malaria Prevention in Travellers, the Department of Health Advisory Committee on Dangerous Pathogens, and advises the National Blood Service on the prevention of transfusion-transmitted parasitic infections.

His research interests include new diagnostic methods for parasitic infections, malaria, Chagas disease and hydatid disease.

In 2018 he was awarded an OBE for services to parasitology and malaria.

Dr Shivan Pancham and Dr Farrukh (Farrah) Shah both present a podcast on the Guidelines for the monitoring and management of iron overload in patients with haemoglobinopathies and rare anaemias.

Both Dr Pancham and Dr Shah discuss the guideline in three main parts:

1) Diagnose and complications of iron overload (Dr Shah)

2) Medications use to treat iron overload (Dr Pancham and Dr Shah)

3) Initialization of iron chelation therapy and maintenance treatment and monitoring for complications of therapy (Dr Pancham and Dr Shah)

Iron overload (IOL), resulting from regular or intermittent blood transfusions or from increasing dietary iron absorption can cause serious and life-threatening complications. Patients at risk of IOL include those with inherited anaemias such as transfusion-dependent thalassaemia (TDT) and non-transfusion-dependent thalassaemia (NTDT), transfused sickle cell disease (SCD) and rarer anaemias such as congenital sideroblastic anaemia (CSA), congenital dyserythropoietic anaemia (CDA), Diamond-Blackfan anaemia (DBA) as well as red cell enzymopathies, membrane disorders and defects in haem synthesis pathways. The United Kingdom has approximately 15 000 patients with these disorders and diagnosis and management of IOL is important in minimising morbidity and mortality. Other disorders that are associated with IOL such as hereditary haemochromatosis or acquired anaemias such as the myelodysplastic syndromes are not covered by this guideline.

The extent and severity of IOL is affected by both the underlying disorder and the intensity and duration of transfusion. Patients on regular top-up transfusions are at most risk whilst those on intermittent transfusions develop IOL more slowly. In the absence of blood transfusion, sickle cell disorders tend not to accumulate excess iron: however, manual and automated exchange transfusion may result in mild degrees of IOL or even iron deficiency.^1-3

Dr Shivan Pancham is a  Consultant Haematologist with Sandwell and West Birmingham NHS Trust. She is one of two lead clinicians for the West Midlands Sickle HCC. She has been a writing group member for the national sickle and thalassaemia guidelines.

Dr Farrukh (Farrah) Shah is a Consultant Haematologist at both the Whittington hospital in London and NHS Blood and Transplant (Colindale). Dr Shah has a specialist interest in the management of transfusional iron overload and haemoglobinopathies. She is actively involved in clinical research in iron chelation and is a local investigator and national investigator for a number of clinical trials.

Dr Andrew Fletcher presents a podcast on the Good Practice Paper for the laboratory diagnosis of iron deficiency in adults (excluding pregnancy) and children.

Dr Fletcher discusses the guideline in three main parts:

1) Laboratory investigations and testing for iron deficiency

2) Advantages and disadvantages of measuring blood counts and ferritin

3) Recommendations

The laboratory diagnosis of iron deficiency is difficult because iron homeostasis is dynamic. No single test can provide an accurate assessment of iron absorption, transport, storage, and utilisation. The different assays available to assess iron and its stores will each be discussed, and recommendations made pertinent to practice within the UK. Iron metabolism in adults and children can be considered equivalent and these recommendations are applicable to both paediatric and adult practice.

Dr Andrew Fletcher is a Consultant Haematologist in paediatric haematology at the Great North Children's Hospital The Newcastle upon Tyne Hospitals NHS Foundation Trusts. His specialist interests are in laboratory medicine, non-malignant haematology and acute myeloid leukaemia.