3 Transplant recipients pre-transplant

Patients not known to have COVID‑19

3.1 Advise patients that for at least 2 weeks before having haematopoietic stem cell transplantation (HSCT), they should follow UK government guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19.

3.2 Test patients for respiratory viruses and COVID‑19 at least once 72 hours before starting conditioning. See the BSBMTCT recommendations for the management of adult patients and allogeneic donors during the COVID-19 outbreak (March 2020).

Autologous transplant recipients

3.3 Defer all but exceptional cases of autologous HSCT for myeloma, low-grade lymphoproliferative diseases and non-malignant indications, with case-by-case decisions made by a multidisciplinary team, until the risks associated with the COVID‑19 pandemic have passed. See the section on prioritising treatment.

Allogeneic transplant recipients

3.4 Defer most cases of allogeneic HSCT for any non-urgent indications and chronic haematological malignancies, with case-by-case decisions made by a multidisciplinary team, until the risks associated with the COVID‑19 pandemic have passed. See the section on prioritising treatment.

3.5 Defer allogeneic HSCT for 3 weeks if possible if the patient has been in close contact with somebody with COVID‑19 within the last week.

Patients known or suspected to have COVID‑19

3.6 Test any patients with symptoms of COVID‑19 for respiratory viruses including COVID‑19 and follow UK government guidance on investigation and initial clinical management of possible cases.

3.7 Defer HSCT by at least 3 months in patients who test positive for COVID‑19, except patients who have a high risk of disease progression, morbidity or mortality.

3.8 For patients who test positive for COVID‑19 and have a high risk of disease progression, morbidity or mortality, defer HSCT until they no longer show symptoms and have 3 repeated negative PCR tests, at least 1 week apart.