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 the professional advice from their clinical team on how best to minimise their risk of respiratory infections (including COVID-19). Guidance for clinicians and patients to support risk assessments is available on the BSBMTCT website. [amended 29 July 2020]

3.2 Test patients for respiratory viruses, including COVID‑19:

  • up to 7 days before admission and

  • on admission before starting conditioning if local testing turnaround times allow. If not, ensure that a test result is available from within the 72 hours before conditioning. [amended 29 July 2020]

3.3 Defer allogeneic HSCT for 2 weeks if possible if the patient has been in close contact with somebody with COVID‑19 within the last week. [amended 10 February 2021]

Patients known or suspected to have COVID‑19

3.4 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.

3.5 For patients who test positive for COVID-19 and do not have a high risk of disease progression, morbidity or mortality, defer HSCT:

  • for a minimum of 2 weeks (preferably 3 weeks) after the first of 3 negative PCR tests (at least 1 week apart) if they are asymptomatic or have mild symptoms

  • for at least 3 months if they have moderate or severe symptoms. [amended 10 February 2021]

3.6 For patients who test positive for COVID‑19 and have a high risk of disease progression, morbidity or mortality, defer HSCT for a minimum of 2 weeks, until they no longer show symptoms and have had 3 negative PCR tests, at least 1 week apart. [amended 10 February 2021]

3.7 Patients who test positive for, or are suspected of having, COVID-19 should undergo repeat echocardiography, pulmonary function tests and chest X-ray before starting treatment. [29 July 2020]