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Life-extending DVRD set to give people in England and Wales remissions of over four years

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Life-extending DVRD set to give people in England and Wales remissions of over four years

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DVRD is aimed at newly-diagnosed patients who are not eligible for a stem cell transplant. It combines daratumumab (Darzalex®), bortezomib (Velcade®), lenalidomide (Revlimid®) and dexamethasone. The latest trial data shows that 68% of people on DVRD were still in remission after four and a half years. 

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New treatment option for Mantel Cell Lymphoma!

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New treatment option for Mantel Cell Lymphoma!

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NICE has approved zanubrutinib as a new option for treating relapsed or refractory mantle cell lymphoma in adults who have had one previous line of treatment.

Zanubrutinib is a type of targeted treatment called a BTK inhibitor. Targeted treatments are medicines that have been specially designed to attack particular proteins on lymphoma cells. BTK inhibitors target and block a protein called Bruton’s tyrosine kinase, which is important for cancer cell survival.

https://lymphoma-action.org.uk/news/new-treatment-available-mantle-cell-lymphoma

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NICE recommends Pembrolizumab for refractory Hodgkin lymphoma! 

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NICE recommends Pembrolizumab for refractory Hodgkin lymphoma! 

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NICE has recommended pembrolizumab for treating relapsed or refractory classical Hodgkin lymphoma for people aged 3 years and over who have had at least 2 previous treatments and cannot have an autologous stem cell transplant. Pembrolizumab is available as a treatment option only if previously treated with brentuximab vedotin. Pembrolizumab treatment is available for two years, but should be stopped sooner if disease progresses or if able to have a stem cell transplant.

Pembrolizumab is a type of targeted drug called a checkpoint inhibitor. Some lymphoma cells are able to hide from your immune system by sticking to a particular protein on T cells. This tells the T cell not to attack. Checkpoint inhibitors block this protein, meaning that your T cells are able to recognise and attack the lymphoma cells.
https://lymphoma-action.org.uk/news/nice-recommends-pembrolizumab-hodgkin-lymphoma

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New treatment for Diffuse Large B Cell Lymphoma [DLBCL]! 

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New treatment for Diffuse Large B Cell Lymphoma [DLBCL]! 

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NICE has recommended Glofitamab plus gemcitabine and oxaliplatin [GlofitGemOx] as an option for treating people with DLBCL. It will be available for adults with DLBCL which has not responded to treatment (refractory) or has returned (relapsed) and who are not suitable for a stem cell transplant. 

Glofitamab is a type of targeted treatment called a bispecific antibody. It works by attaching to two targets, one on the surface of lymphoma cells and one on the surface of T cells (part of the immune system). This means that cells of the immune system come into direct contact with the lymphoma cells, and this leads to activation of the T-cells which in turn kill the lymphoma cells.  

https://lymphoma-action.org.uk/news/nice-recommends-new-treatment-dlbcl

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NICE has approved brentuximab vedotin as a new treatment in the management of Hodgkin lymphoma in England and Wales. It is recommended in combination with doxorubicin, dacarbazine and vinblastine for use in people with stage 3 or 4 CD30-positive disease who have not yet received any treatment.

Brentuximab vedotin is a type of targeted treatment called an antibody-drug conjugate. This is where a monoclonal antibody is joined to a small dose of chemotherapy drug. The antibody sticks to a protein on the lymphoma cells, in this case CD30, and delivers the chemotherapy directly to them. 

https://lymphoma-action.org.uk/news/new-treatment-hodgkin-lymphoma-recommended-nice

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New first target treatment for Marginal Zone Lymphoma! 

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New first target treatment for Marginal Zone Lymphoma! 

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NICE has recommended zanubrutinib as an option for treating relapsed or refractory marginal zone lymphoma (MZL) in adults.

Zanubrutinib is recommended as a treatment option for MZL in adults who have already been treated with an anti-CD20 based treatment such as rituximab. 

Zanubrutinib is the first targeted treatment to be recommended for people with marginal zone lymphoma. Targeted treatments are medicines that have been specially designed to attack particular proteins on lymphoma cells. Zanubrutinib is a BTK inhibitor, it targets and blocks a protein called Bruton’s tyrosine kinase (BTK), which is important for cancer cell survival.

https://lymphoma-action.org.uk/news/nice-recommends-first-targeted-treatment-mzl

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New Chronic Lymphocytic Leukaemia [CLL] treatment! 

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New Chronic Lymphocytic Leukaemia [CLL] treatment! 

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NICE have approved the treatment of Venetoclax with Obinutuzumab as a new treatment for untreated CLL patients. 

Venetoclax is a type of targeted treatment called a BCL-2 inhibitor. B-cell lymphoma-2 (BCL-2) is a protein that can help lymphoma cells to stay alive longer than they should. BCL-2 inhibitors block this protein, activating cell death.

Obinutuzumab is a monoclonal antibody therapy that sticks to the protein CD20. By sticking to the protein it activates your immune system to destroy the lymphoma cell that is making the protein. 

https://lymphoma-action.org.uk/news/new-treatment-cll-recommended-nice

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NICE recommends Loncastuximab for refractory DLBCL! 

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NICE recommends Loncastuximab for refractory DLBCL! 

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NICE has recommended Loncastuximab as an option for treating relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma in adults after 2 or more systemic therapies. The treatment option is only available if they have previously been treated with Polatuzumab vedotin, or if polatuzumab vedotin is not suitable.

Loncastuximab is a type of targeted treatment, known as an antibody-drug conjugate. Antibody–drug conjugates are monoclonal antibodies joined to a chemotherapy drug. The antibody is designed to stick to a protein on lymphoma cells and carry the chemotherapy drug directly to them. 
https://lymphoma-action.org.uk/news/nice-recommends-loncastuximab-tesirine-dlbcl

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NICE recommends Glofitamab for refractory DLBCL! 

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NICE recommends Glofitamab for refractory DLBCL! 

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NICE has recommended Glofitamab as an option for treating relapsed or refractory diffuse large B-cell lymphoma (DLBCL) in adults after 2 or more systemic therapies. 
https://lymphoma-action.org.uk/news/nice-recommends-glofitamab-dlbcl

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Both Dr Anderson and Dr Lewis care for patients with bleeding disorders such as Von Willebrand, haemophillia A + B, Immune thrombocytopenic purpura (ITP), hemochromatosis and much more. They also run the anticoagulation clinics where they review patient's who have recently been diagnosed with a DVT. 

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Welcome to Haematology!                                                    
Congratulations on joining the team! We're excited to have you on board and look forward to working together. This is your go-to guide for everything you need to know about haematology, whether you're about to join us or are already a part of our team.           

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Our haematology services span across 3 sites. Here are the contact details for our 3 sites.                                                          
Please feel free to contact us, We are more than happy to answer any questions! 

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In Aneurin Bevan University Health Board (ABUHB), Haematology services are over 3 sites. Inpatients are based in the Grange University Hospital (GUH), Outpatients are based in Nevill Hall Hospital (NHH) and Royal Gwent Hospital (RGH). The Haematology service covers the complete North and South Gwent areas. 

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Medical Day Case Unit – Royal Gwent Hospital, Floor 3 (opposite the canteen) Royal Gwent Hospital, Cardiff Road, Newport, NP20 2UB.   Telephone Number: 01633 234647                                                              

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Staff shifts are either 08:00-16:00 or 09:00-17:00.         Daily staffing: 4 RN's and 1 HCSW 

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Haematology Day Unit – Nevill Hall Hospital, Ward 2/4, Nevill Hall Hospital, Brecon Rd, Abergavenny, NP7 7EG.                                           Telephone Number: 01873 732410

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Staff shifts are 08:30-16:30.                                      Daily staffing: 3 RN's and 1 HCSW 

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B4 Haematology – Grange University Hospital, Ward B4 (4th Floor), Grange University Hospital, Llanyravon, Cwmbran, NP44 8YN.  Telephone Number: 01633 493997

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Haematology Practitioners: Rhiannon Coles and Jaydine Carr

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We are a team of dedicated healthcare professionals committed to delivering the highest quality of care to our patients. We take immense pride in our work and the impact it has. In our day unit, we offer assessments, chemotherapy and non-chemotherapy treatments, as well as ongoing support for patients with various haematological conditions. Some of the treatments we provide include blood and platelet transfusions, immunoglobulin infusions, iron infusions, intravenous and subcutaneous chemotherapy, and venesections

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The haematology directorate aims to provide safe, timely and appropriate care to patients. The final agreed mission statement is 'To be at the forefront of providing evidence based convenient, co-ordinated care across the spectrum of haematology services to the population of ABUHB. 

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Staff must adhere to the NHS Wales Dress Code principles and policy. 

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Staff must adhere to the NHS Wales Dress Code principles and policy. 

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- Staff must wear clean uniform to each shift.               - Clean uniform/work attire must be worn for each shift/work day.                                                        - You must not wear anything on your wrists.                - No jewellery allowed apart from plain wedding bands and one set of ear studs.                                            - No false nails or nail varnish. Fingernails must be kept short and clean.                                                       - Staff must wear footwear that complies with the relevant health and safety requirements, for example, soft soled for reduced noise, low heeled for manual handling and ease of movement, and closed toes for protection.      

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Myeloma, specifically multiple myeloma, is a type of cancer that impacts plasma cells, a type of white blood cell located in the bone marrow. Plasma cells are responsible for producing antibodies that help combat infections. Multiple myeloma occurs when DNA damage happens during the development of a plasma cell. This results in the production of abnormal cells that release large amounts of a single type of antibody, known as paraprotein, which serves no useful purpose.

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Gemma Scott- Consultant Haematologist                   Lowri Morgan- Consultant Haematologist                   Victoria Ware- Consultant Haematologist                                                                                                   Alison Pugh (Macmillan Myeloma CNS)                 Natalie Poore (Macmillan Myeloma CNS)  

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Plasma cell conditions are a group of disorders that involve the abnormal growth or dysfunction of plasma cells, a type of white blood cell responsible for producing antibodies to help the body fight infections. These conditions can lead to a variety of health problems, as the abnormal plasma cells may crowd out normal blood cells, produce ineffective antibodies, or cause damage to organs and tissues.

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Lymphoma is a type of cancer that begins in the lymphatic system, which is part of the body's immune system. The lymphatic system includes lymph nodes, spleen, tonsils, and bone marrow, and it helps protect the body from infections. Lymphoma develops when lymphocytes, a type of white blood cell, grow uncontrollably. 

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Rachel Elliot- Consultant Haematologist                        Nilma Parry-Jones- Consultant Haematologist               Victoria Williams- Consultant Haematologist                  Rachel Trickey-  Consultant Haematologist                                                                                          Tracey Gunter- (Macmillan lymphoid CNS)                  Sian Poore- (Lymphoid CNS)       

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Leukemia is a type of cancer that affects the blood and bone marrow, where blood cells are produced. It begins when abnormal white blood cells are produced in large numbers and grow uncontrollably. These abnormal cells can crowd out healthy blood cells, leading to problems with the immune system, red blood cells, and platelets. There are several types of leukemia, which are generally classified based on how quickly they develop (acute or chronic) and the type of white blood cell affected (lymphocytic or myelogenous)

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Christopher Jenkins- Consultant Haematologist            Ali Mahdi- Consultant Haematologist                            Eamon Mahdi- Consultant Haematologist                                                                                            Joedy Davies- (Myeloid CNS) She runs a nurse led clinic for patients with Essential Thrombocythaemia and Polycythaemia. Additionally Joedy is the key worker for Myelofibrosis and CML.                                                                                                                         Alicia Harris (Myeloid CNS) is the key worker for patients with Myelodysplasia and Acute Myeloid Leukaemia. She also looks after our group of Haemochromatosis patients.   

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Introduction workbooks for new starters 

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Introduction workbooks for new starters 

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Haematology Induction Updated July 2022 1

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Jessica Anderson- Consultant Haematologist              Sarah Lewis- Consultant Haematologist                       Alicia Harris (Myeloid CNS) is the key worker for patients with hemochromatosis. 

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Cutting-edge BPD approved at second line in world-first.  This second line treatment could give people remissions of nearly three years. BPD has been shown to stop myeloma in its tracks for more than 32 months on average. 
BPD combines belantamab, pomalidomide and dexamethasone (BPD) and is aimed at people who have received one previous line of treatment including lenalidomide.  
https://www.myeloma.org.uk/news/cutting-edge-bpd-approved-at-second-line-in-world-first/

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First quadruplet treatment for transplant-ineligible patients approved in England and Wales!

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First quadruplet treatment for transplant-ineligible patients approved in England and Wales!

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Around 3,300 patients could benefit from the treatment, known as IsaVRD, each year. 

The quadruplet combines isatuximab, bortezomib , lenalidomide and dexamethasone. It is aimed at newly-diagnosed patients who are not eligible for a stem cell transplant.

According to the latest trial data, 63% of people on the treatment were still in remission after five years.
https://www.myeloma.org.uk/news/first-quadruplet-treatment-for-transplant-ineligible-patients-approved-in-england-and-wales/

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Victory as first treatment for AL amyloidosis approved after NICE!

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Victory as first treatment for AL amyloidosis approved after NICE!

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Patients with AL amyloidosis have claimed a hard-fought victory after the very first treatment for the incurable disease was approved on the NHS, following a U-turn by NICE.

59% of patients who received DaraCyBorD also had no sign of AL amyloidosis 20 months after treatment and longer remission times.

DaraCyBorD is a combination of four drugs:   

Daratumumab (Darzalex®)   
Cyclophosphamide   
Bortezomib (Velcade®)   
Dexamethasone . 
https://www.myeloma.org.uk/news/victory-as-first-treatment-for-al-amyloidosis-approved-after-nice-u-turn/

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Obecabatagene autoleucel CAR-T approved by NICE! 

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Obecabatagene autoleucel CAR-T approved by NICE! 

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Obecabtagene autoleucel (obe-cel) has been approved for use on NHS in most of the UK. It is a type of CAR-T cell therapy for certain adults with B cell acute lymphoblastic leukaemia (ALL). Although this is yet to be approved by Wales. 

Clinical studies have shown obe-cel to be an effective treatment for relapsed or refractory ALL. Also obe-cel cells are engineered to stick around for longer in the body to fight off future leukaemia cells. It is tricky to treat ALL in adults, so further effective options for treatment are important. 
https://www.leukaemiacare.org.uk/support-and-information/latest-from-leukaemia-care/news/obecabatagene-autoleucel-car-t-approved-by-nice-what-you-need-to-know/

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Information leaflet provided for newly diagnosed patients. 

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Many of our patients receive intensive chemotherapy, which can be particularly demanding on their veins. As a result, they often have a Peripherally Inserted Central Catheter (PICC) in place. To safely access these lines, nurses are required to complete their ANTT online training in addition to this practical workshop.

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PICC Line Care and Maintenance Structured Training Development Portfolio

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The following guidelines are designed to assist healthcare professionals in referral of patients 
from primary and secondary care to the Department of Haematology. 

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NICE recommends acalabrutinib for mantle cell lymphoma and CLL

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NICE recommends acalabrutinib for mantle cell lymphoma and CLL

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NICE has published final draft guidance recommending the use of acalabrutinib with bendamustine and rituximab for untreated mantle cell lymphoma in adults who are not eligible for an autologous stem cell transplant. 

Clinical evidence showed that adding acalabrutinib to bendamustine and rituximab helped keep the condition under control for longer, increasing the average time before it worsened.

This recommendation increases treatment options for eligible patients with MCL, helping them find a treatment that fits their individual needs and way of life.

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NICE recommends lisocabtagene maraleucel for large B-cell lymphoma. 

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NICE recommends lisocabtagene maraleucel for large B-cell lymphoma. 

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This week NICE has published guidance recommending the use of lisocabtagene maraleucel as an option to treat relapsed or refractory diffuse large B-cell lymphoma (DLBCL) or primary mediastinal large B-cell lymphoma (PMBL) after two or more lines of systemic treatment in adults. 

Lisocabtagene maraleucel (known as liso-cel) is a CAR-T cell therapy, a type of treatment that uses cells from your own immune system to fight lymphoma