37 leading clinicians call for more Government support for people with blood cancer

The group, which includes some of the UK’s leading haematologists and immunologists, has issued a joint statement (see below) expressing concern that government guidance for the clinically extremely vulnerable is too broad to be useful for people with blood cancer. This is because the compromised immune systems of many people with blood cancer mean they may be less protected by the vaccine, as well as more likely to become seriously ill if they contract covid.

The group is calling on the Government to urgently inform people with blood cancer about their likely response to the vaccine, as a previous survey by Blood Cancer UK showed that 80% of people with blood cancer had not been told the vaccine may be less effective for them. The group is also calling for financial support for people with blood cancer, amid concerns that some of them could feel forced to continue attending busy workplaces.

Gemma Peters, Chief Executive of Blood Cancer UK, said: “The fact that so many leading clinicians are speaking with one voice to call for Government action shows their level of concern about the risks facing people with blood cancer in the coming weeks.

“Despite lots of studies now having showed that people with blood cancer are less likely to produce antibodies after the vaccine, the Government guidance contains little practical support for them to keep themselves safe. The fact that the Government and the NHS have not even informed many of them that they may be less protected means that many thousands of people do not even have the basic information they need to help keep themselves safe.

“While it is good that furlough is available for people with blood cancer over the next few weeks, we are in a position where people are relying on the goodwill of their employers to stay safe. It cannot be right that if the employer of someone immunocompromised will not furlough them, then they are expected to have to put their health at risk by continue going into work.”

The Government has published its guidance for people who are Clinically Extremely Vulnerable, who had previously been advised to shield.

The guidance does not reflect the specific risks for many people with blood cancer.

This will cause confusion for people with blood cancer and the wider public. As Covid-19 rates are rapidly rising, confusion over who may or may not be protected after vaccination is dangerous.

Evidence from studies in the UK and internationally have consistently shown that:

• Some people with blood cancer are at higher risk of poorer outcomes fromCovid-19 because their immune systems are suppressed, both due to the nature of the disease and the treatments they receive
• Antibody responses after vaccination tend to be lower in people with some blood cancers than those of immune competent individuals
• Some people with blood cancer do not mount any antibody response at all to the vaccines. This includes, as specific examples, patients who have recently been on immunosuppressive treatments and those living with conditions that affect the function of B-cells needed to produce antibodies
• More evidence is needed to understand how the immune system responds to the Covid-19 vaccines – this evidence is currently being collected

We are asking the Government to ensure that specific, and adequate support is in place for people with blood cancer, given the evidence so far suggests that many may not be robustly immune to Covid-19 despite receiving two doses of vaccine. In particular, we call on the Government to:

• Be guided by evidence from existing studies about response to vaccines, rather than making generalised assertions about levels of protection across immunocompromised patients.
• Issue specific communication and guidance to people with blood cancer to ensure that they are aware of the likely level of protection from the vaccine, and provide practical support, including financial support, so they are able to make informed decisions.

Gemma Peters, CEO, Blood Cancer UK

Laura Kerby, CEO, Myeloma UK

Professor Adele Fielding, Professor of Haematology and Consultant Haematologist, University College London. President of the British Society for Haematology

Professor Antonio Pagliuca, Chief Medical and Scientific Adviser, Anthony Nolan; Divisional Medical Director and Professor of Stem Cell Transplantation at King’s College Hospital NHS Foundation Trust

Professor Emma Morris, Director, UCL Division of Infection and Immunity, Professor of Clinical Cell and Gene Therapy, UCL Institute of Immunity & Transplantation.

Professor Gordon Cook, Professor of Haematology & Myeloma Studies, Clinical Director (Haematology), Leeds Institute of Clinical Trials Research Unit

Dr Thushan De Silva, Senior Clinical Lecturer and Honorary Consultant Physician in Infectious Diseases, University of Sheffield

Professor Claire Harrison, Professor of myeloproliferative neoplasms and Clinical Director for Haematology, Guy’s and St Thomas’

Dr Kim Orchard, Senior Lecturer and Consultant Haematologist, Director, Wessex Blood and Marrow Transplant Programme

Dr Toby Eyre, Haematology Consultant and Honorary Senior Clinical Lecturer in Haematology, University of Oxford

Professor George Vassiliou, Professor of Haematological Medicine at the University of Cambridge and Consultant Haematologist at Cambridge University Hospitals

Dr Dinis Calado, Immunity and Cancer Laboratory, The Francis Crick Institute

Professor Adrian Hayday, Professor of Immunobiology, Kings College London

Professor Irene Roberts, Emeritus Professor of Paediatric Haematology, University of Oxford

Dr Anindita Roy, Associate Professor of Paediatric Haematology, University of Oxford

Dr Graham Collins, Consultant Haematologist, University of Oxford

Dr Sheeba Irshad, Clinician Scientist & Honorary Medical Oncologist, King’s College London

Professor Graham Jackson, Professor of Clinical Haematology, University of Newcastle

Dr Sean Lim, Consultant Haematologist and Cancer Immunologist at the University of Southampton

Professor Jude Fitzgibbon, Professor of Personalised Medicine, Queen Mary University of London

Professor Kwee Yong, Professor of Clinical Haematology, UCLH

Dr Alison Michie, Reader in Molecular Lymphopoiesis, Institute of Cancer Sciences, University of Glasgow

Dr Bela Wrench, Clinical Senior Lecturer, Bart’s Cancer Institute

Professor Alex Richter, Professor and Honorary Consultant in Clinical Immunology, University of Birmingham

Professor Chris Bunce, Professor of Translational Cancer Biology, University of Birmingham

Dr Christopher Fox, Consultant Haematologist, Nottingham University Hospitals NHS Trust Honorary Clinical Associate Professor, University of Nottingham

Dr Jessica Okosun, Clinical Senior Lecturer, Barts Cancer Institute

Dr Kevin Boyd, Consultant Haematologist, Clinical Service Lead for Myeloma, The Royal Marsden NHS Foundation Trust

Dr Robert Marcus, Consultant Haematologist, LOC Harley St and Chelsea, and London Bridge Hospital

Professor Asim Khwaja, Professor of Haematology & Consultant Haematologist, UCL and UCLH NHS Foundation Trust

Professor Andrew Pettit, Professor of Experimental Medicine and Honorary Consultant Haematologist, University of Liverpool

Professor Brian Huntly, Head of Department and Professor of Leukaemia Stem Cell Biology and Consultant Haematologist at Addenbrooke’s Hospital

Dr Kirit Ardeshna, Consultant Haemato-oncologist and Divisional Clinical Director - Cancer, UCLH

Dr Jane Stevens, Consultant Haematologist, Dartford and Gravesham NHS Trust

Jodie Nightingill, RGN/INP Clinical Nurse Specialist for Haematology, Mid and South Essex, NHS Foundation Trust

Dr Charlotte Wilhelm-Benartzi, Research Fellow, Cardiff University

Dr Piers Patten, Clinical Senior Lecturer and Honorary Consultant Haematologist, King’s College London